Healthcare Provider Details

I. General information

NPI: 1598171241
Provider Name (Legal Business Name): MICHAEL PATRICK ENGLAND FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2014
Last Update Date: 08/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 6TH AVE
KINDER LA
70648
US

IV. Provider business mailing address

1628 DEERFIELD DR
LAKE CHARLES LA
70611-3753
US

V. Phone/Fax

Practice location:
  • Phone: 337-738-9494
  • Fax: 337-738-9449
Mailing address:
  • Phone: 337-499-6369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP07913
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: