Provider Demographics
NPI:1427505577
Name:MANAFI, MEREDITH BOUSTANY (PA-C)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:BOUSTANY
Last Name:MANAFI
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:604 N ACADIA RD STE 101
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-4897
Mailing Address - Country:US
Mailing Address - Phone:985-446-5079
Mailing Address - Fax:985-447-2497
Practice Address - Street 1:100 PHOENIX DR
Practice Address - Street 2:
Practice Address - City:ABBEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70510-2396
Practice Address - Country:US
Practice Address - Phone:337-898-3700
Practice Address - Fax:337-898-3702
Is Sole Proprietor?:No
Enumeration Date:2016-09-07
Last Update Date:2024-03-14
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Provider Licenses
StateLicense IDTaxonomies
LA303565363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant