Provider Demographics
NPI:1992048425
Name:TEMPLET, ELAINE MARIE (RN, BSN)
Entity type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:MARIE
Last Name:TEMPLET
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 N BURNSIDE AVENUE
Mailing Address - Street 2:SUITE C PMB #6
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737
Mailing Address - Country:US
Mailing Address - Phone:850-565-0663
Mailing Address - Fax:188-877-4835
Practice Address - Street 1:1414 N BURNSIDE AVE
Practice Address - Street 2:SUITE C, PMB #6
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-2154
Practice Address - Country:US
Practice Address - Phone:850-565-0663
Practice Address - Fax:188-877-4835
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-03
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN042697171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor