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Individual

MRS. TAMERA L FONTENOT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
401 AUDUBON BLVD, LAFAYETTE, LA 70503-2676
(337) 237-7801
Mailing address
284 JOHNSON RD, VILLE PLATTE, LA 70586-6885
(337) 363-1807

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP03106
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1697532
LA
Enumeration date
08/30/2006
Last updated
06/05/2009
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