Provider Demographics
NPI:1164159208
Name:BRELAND, ALEXANDRA KATHRYN (NP)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:KATHRYN
Last Name:BRELAND
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:985-234-3000
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:7015 HIGHWAY 190 EAST SERVICE RD STE 200
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-4960
Practice Address - Country:US
Practice Address - Phone:985-234-3000
Practice Address - Fax:985-234-3001
Is Sole Proprietor?:No
Enumeration Date:2022-08-08
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA226841363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner