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Individual

MS. DIANE FONTENETTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
1141 WHITNEY AVE, BLDG 4, GRETNA, LA 70056-5011
(972) 391-4085
(504) 347-1782
Mailing address
1141 WHITNEY AVE, BLDG 4, GRETNA, LA 70056-5011
(972) 391-4085
(504) 347-1782

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
780887
LA

Other

Enumeration date
08/30/2013
Last updated
08/30/2013
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