Healthcare Provider Details

I. General information

NPI: 1316638539
Provider Name (Legal Business Name): RAQUEL ORTELLI MORROW APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2023
Last Update Date: 10/01/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 ERNEST ST
LAKE CHARLES LA
70601-8406
US

IV. Provider business mailing address

2701 ERNEST ST
LAKE CHARLES LA
70601-8406
US

V. Phone/Fax

Practice location:
  • Phone: 337-439-0336
  • Fax:
Mailing address:
  • Phone: 337-439-0336
  • Fax: 337-494-0546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number230645
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN143504
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: