Individual
DENISHIA NEVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
302 DULLES DR, LAFAYETTE, LA 70506-3008
(337) 262-4100
Mailing address
302 DULLES DR, LAFAYETTE, LA 70506-3008
(337) 262-4100
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
20130067
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710032
MEDICAID PROVIDER NUMBER
LA
Enumeration date
07/23/2015
Last updated
07/23/2015
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