Basic Information
| Provider Information | |||||||||
| NPI: | 1932355021 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LAFRANCE | ||||||||
| FirstName: | JEANNINE | ||||||||
| MiddleName: | B | ||||||||
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| Credential: | ANP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 501 W SAINT MARY BLVD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | LAFAYETTE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 705064600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3372357898 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2309 E MAIN ST | ||||||||
| Address2: | SUITE 301 | ||||||||
| City: | NEW IBERIA | ||||||||
| State: | LA | ||||||||
| PostalCode: | 705604046 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3373644475 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/08/2008 | ||||||||
| LastUpdateDate: | 08/08/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 364SA2200X | AP05567 | LA | Y | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Adult Health |
No ID Information.