Individual
CHRISTOPHER BLAINE VINCENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
202 BEVINGTON DR, LAFAYETTE, LA 70508-5443
(337) 412-4506
Mailing address
202 BEVINGTON DR, LAFAYETTE, LA 70508-5443
(337) 412-4506
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
220764
LA
Other
Enumeration date
06/09/2021
Last updated
08/03/2021
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