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1508510413
JACOB ANTHONY CHAMPAGNE
LAFAYETTE, LA
NPI
1508510413
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: LA 224252)
Enumeration Date
2022-02-09
Last Update Date
2022-02-09
Business Address
Mr. JACOB ANTHONY CHAMPAGNE FNP-C
4801 AMBASSADOR CAFFERY PKWY
LAFAYETTE, LA 70508-6917
Phone number: 337-470-2911
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Mailing Address
Mr. JACOB ANTHONY CHAMPAGNE FNP-C
133 MADDOX JUDE DR
MAURICE, LA 70555-3355
Phone number: 337-230-0104
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