Healthcare Provider Details

I. General information

NPI: 1174819668
Provider Name (Legal Business Name): DANA BETH FONTENOT APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DANA BETH FONTENOT APRN FNP

II. Dates (important events)

Enumeration Date: 06/22/2011
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1587 N BOLTON AVE STE 1100
ALEXANDRIA LA
71303-4255
US

IV. Provider business mailing address

1587 N BOLTON AVE STE 1100
ALEXANDRIA LA
71303-4255
US

V. Phone/Fax

Practice location:
  • Phone: 318-709-9051
  • Fax: 318-445-1509
Mailing address:
  • Phone: 318-709-9051
  • Fax: 318-445-1509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN112634-AP06478
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: