Healthcare Provider Details

I. General information

NPI: 1164353199
Provider Name (Legal Business Name): DEON ANTOINE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6299 CALION DR
BATON ROUGE LA
70812-1904
US

IV. Provider business mailing address

6299 CALION DR
BATON ROUGE LA
70812-1904
US

V. Phone/Fax

Practice location:
  • Phone: 225-678-0272
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number008528936
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: