Healthcare Provider Details

I. General information

NPI: 1255377313
Provider Name (Legal Business Name): HENRIETTA LEE CHAMBERS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 01/28/2026
Certification Date: 01/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1409 CHURCH ST
JEANERETTE LA
70544-4407
US

IV. Provider business mailing address

302 HACKER ST
NEW IBERIA LA
70560-4508
US

V. Phone/Fax

Practice location:
  • Phone: 337-276-6018
  • Fax: 337-901-5805
Mailing address:
  • Phone: 337-330-2576
  • Fax: 337-417-9909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number04514
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number04514
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number073547
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: