Healthcare Provider Details

I. General information

NPI: 1144169541
Provider Name (Legal Business Name): SENTRENAE NICOLE SENEGAL FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 BANISTER CT APT 1102
LAFAYETTE LA
70507-3258
US

IV. Provider business mailing address

111 BANISTER CT APT 1102
LAFAYETTE LA
70507-3258
US

V. Phone/Fax

Practice location:
  • Phone: 337-500-2549
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2026019616
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number204317
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number204317
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: