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1205425154
BRANDY FONTENOT
LAKE CHARLES, LA
NPI
1205425154
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: LA 219160)
Enumeration Date
2021-01-14
Last Update Date
2023-06-14
Business Address
BRANDY FONTENOT
630 BRIARWOOD DR
LAKE CHARLES, LA 70605-1518
Phone number: 337-526-1364
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Mailing Address
BRANDY FONTENOT
630 BRIARWOOD DR
LAKE CHARLES, LA 70605-1518
Phone number:
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