Provider Demographics
NPI:1396758652
Name:PREJEANT, KRISTI C (MD)
Entity type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:C
Last Name:PREJEANT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1302 LAKEWOOD DR.
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MORGAN CITY
Mailing Address - State:LA
Mailing Address - Zip Code:70380
Mailing Address - Country:US
Mailing Address - Phone:985-384-3433
Mailing Address - Fax:985-384-3453
Practice Address - Street 1:1302 LAKEWOOD DR.
Practice Address - Street 2:SUITE 202
Practice Address - City:MORGAN CITY
Practice Address - State:LA
Practice Address - Zip Code:70380
Practice Address - Country:US
Practice Address - Phone:985-384-3433
Practice Address - Fax:985-384-3453
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK23462146D00000X
LAMD.204181208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant