Individual
CASEY FONTENOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
601 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5726
(337) 436-1370
Mailing address
501 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5724
(337) 312-8258
(337) 312-6708
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP08325
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2396773
—
LA
Enumeration date
06/29/2015
Last updated
08/22/2022
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