Healthcare Provider Details

I. General information

NPI: 1003706326
Provider Name (Legal Business Name): MRS. ANGELLE ARCENEAUX
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2025
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3419 NW EVANGELINE TRWY STE M-13
CARENCRO LA
70520-6241
US

IV. Provider business mailing address

4801 AMBASSADOR CAFFERY PKWY
LAFAYETTE LA
70508-6917
US

V. Phone/Fax

Practice location:
  • Phone: 337-520-5522
  • Fax:
Mailing address:
  • Phone: 337-520-5522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number248887
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: