Provider Demographics
NPI:1104248483
Name:GOUDEAU, COURTNEY N (CRNA)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:N
Last Name:GOUDEAU
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:
Other - Last Name:RYDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 8278
Mailing Address - Street 2:RED RIVER ANESTHESIA OF ALEXANDRIA
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71306
Mailing Address - Country:US
Mailing Address - Phone:318-484-5280
Mailing Address - Fax:318-442-3134
Practice Address - Street 1:651 NORTH BOLTON AVENUE
Practice Address - Street 2:CENTRAL LOUISIANA SURGICAL HOSPITAL
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301
Practice Address - Country:US
Practice Address - Phone:318-443-3511
Practice Address - Fax:318-442-1586
Is Sole Proprietor?:No
Enumeration Date:2014-01-06
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN122387163W00000X
LAAP07621367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse