Provider Demographics
NPI:1942226642
Name:LASTRAPES, DEBORRAH A (MW)
Entity type:Individual
Prefix:MRS
First Name:DEBORRAH
Middle Name:A
Last Name:LASTRAPES
Suffix:
Gender:F
Credentials:MW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 SERENITY DR
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70592-5135
Mailing Address - Country:US
Mailing Address - Phone:337-856-7482
Mailing Address - Fax:
Practice Address - Street 1:322 SERENITY DR
Practice Address - Street 2:
Practice Address - City:YOUNGSVILLE
Practice Address - State:LA
Practice Address - Zip Code:70592-5135
Practice Address - Country:US
Practice Address - Phone:337-856-7482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMW0406176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife