Provider Demographics
NPI:1154613651
Name:BREAUX, CANDACE ARNOUVILLE (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:CANDACE
Middle Name:ARNOUVILLE
Last Name:BREAUX
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7515 PERKINS RD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4330
Mailing Address - Country:US
Mailing Address - Phone:225-769-6084
Mailing Address - Fax:
Practice Address - Street 1:7515 PERKINS RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4330
Practice Address - Country:US
Practice Address - Phone:225-769-6084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-03
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA45503183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist