Healthcare Provider Details

I. General information

NPI: 1528873395
Provider Name (Legal Business Name): CHRISTINA BENNETT DEBAUTTE MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2025
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41676 VETERANS AVE
HAMMOND LA
70403-1412
US

IV. Provider business mailing address

1514 JEFFERSON HWY
NEW ORLEANS LA
70121-2483
US

V. Phone/Fax

Practice location:
  • Phone: 985-543-3600
  • Fax:
Mailing address:
  • Phone: 504-842-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number239760
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: