Healthcare Provider Details

I. General information

NPI: 1437160231
Provider Name (Legal Business Name): SIMONE ADEL PITRE C-NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 11/02/2020
Certification Date: 11/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 N STATE ST
ABBEVILLE LA
70510-2825
US

IV. Provider business mailing address

110 CURRAN LN
LAFAYETTE LA
70506-7222
US

V. Phone/Fax

Practice location:
  • Phone: 337-422-6240
  • Fax: 337-422-6241
Mailing address:
  • Phone: 337-706-7700
  • Fax: 337-706-7710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number67000-3451
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAP03451
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: