Individual
CRYSTAL ARDOIN FONTENOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2000 OPELOUSAS ST, LAKE CHARLES, LA 70601-2641
(337) 439-9983
(337) 439-9250
Mailing address
2000 OPELOUSAS ST, LAKE CHARLES, LA 70601-2641
(337) 439-9983
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN103946-AP05780
LA
Other
Enumeration date
05/19/2009
Last updated
11/04/2011
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