Individual
MR. MATT JUDE LANDRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
N.P.
Contact information
Practice address
443 HEYMANN BLVD, STE. B, LAFAYETTE, LA 70503-2630
(337) 289-8429
(337) 289-8431
Mailing address
PO BOX 4176, HOUMA, LA 70361-4176
(985) 872-5864
(985) 872-0317
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP06784
LA
363LA2200X
Adult Health Nurse Practitioner
AP06784
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2193601
—
LA
Enumeration date
03/02/2012
Last updated
03/15/2017
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