Healthcare Provider Details

I. General information

NPI: 1811812225
Provider Name (Legal Business Name): GENWELL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

512 COLONIAL DR
LAKE CHARLES LA
70611-5365
US

IV. Provider business mailing address

512 COLONIAL DR
LAKE CHARLES LA
70611-5365
US

V. Phone/Fax

Practice location:
  • Phone: 337-707-0774
  • Fax:
Mailing address:
  • Phone: 337-707-0774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MS. DANELLA MARIE TAYLOR-SONNIER
Title or Position: OWNER
Credential: NP
Phone: 337-707-0774