Individual
CELENIA A STANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
202 WESTGATE RD, LAFAYETTE, LA 70506-2711
(337) 232-1802
Mailing address
418 PATIN RD, CARENCRO, LA 70520-5544
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
310257
LA
Other
Enumeration date
08/14/2018
Last updated
09/28/2020
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