Individual
MARY SAMANTHA DARBONNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2000 SOUTHWOOD DR, LAKE CHARLES, LA 70605-4181
(337) 474-2856
Mailing address
4865 KINGSPOINT DR, LAKE CHARLES, LA 70605-5985
(337) 474-9756
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
219390
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2581767
—
LA
Enumeration date
04/22/2021
Last updated
07/20/2022
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