Individual
BRANDY FONTENOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
801 W BAYOU PINES DR, LAKE CHARLES, LA 70601-7076
(337) 404-4075
Mailing address
801 W BAYOU PINES DR, LAKE CHARLES, LA 70601-7076
(337) 404-4075
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
219160
LA
Other
Enumeration date
01/14/2021
Last updated
03/22/2026
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