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Individual

MRS. GRACE EKANEM DINVAUT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
1050 N ROBINSON ST, MANY, LA 71449
(318) 256-8150
(318) 256-8136
Mailing address
806 JEFFERSON TER, NEW IBERIA, LA 70560-5727
(337) 365-4945
(318) 256-8136

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP06280
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2129180
LA
01
58-2164455
TAX ID
01
CDS.041111-APN
CDS
LA
01
PA021170CS
PRESCRIPTIVE AUTHORITY
LA
Enumeration date
08/26/2010
Last updated
03/07/2023
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