Individual
MRS. AFRICA BLACK DAUPHINEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3400 MOSS ST STE B, LAFAYETTE, LA 70507-6114
(337) 454-3352
(337) 454-3359
Mailing address
PO BOX 62504, LAFAYETTE, LA 70596-2504
(337) 454-3352
(337) 454-3359
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN120812
LA
363LA2200X
Adult Health Nurse Practitioner
Primary
RN120812-AP06643
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2181254
—
LA
01
—
3D060CA15
MEDICARE GROUP MEMBER PTAN
LA
Enumeration date
08/24/2011
Last updated
10/05/2020
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