Individual
DIANA FONTENOT ROY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2390 W CONGRESS ST, LAFAYETTE, LA 70506-4205
(337) 261-6272
Mailing address
104 MISSION HILLS, BROUSSARD, LA 70518
(337) 856-0747
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
36487
LA
Other
Enumeration date
10/26/2005
Last updated
07/08/2007
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