Healthcare Provider Details

I. General information

NPI: 1588143945
Provider Name (Legal Business Name): ELIZABETH ARCENEAUX FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2018
Last Update Date: 08/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

327 BAYOU GARDENS BLVD
HOUMA LA
70364-1434
US

IV. Provider business mailing address

327 BAYOU GARDENS BLVD
HOUMA LA
70364-1434
US

V. Phone/Fax

Practice location:
  • Phone: 985-876-5000
  • Fax: 985-876-5280
Mailing address:
  • Phone: 985-876-5000
  • Fax: 985-876-5280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP10063
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: