Healthcare Provider Details

I. General information

NPI: 1720154461
Provider Name (Legal Business Name): DARRELL J PRICE APRN FNPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 07/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

843 MILLING AVE
LULING LA
70070-4442
US

IV. Provider business mailing address

101 DOLPHIN ST
MONTEGUT LA
70377-2321
US

V. Phone/Fax

Practice location:
  • Phone: 985-785-5800
  • Fax: 985-785-5811
Mailing address:
  • Phone: 504-579-2552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN071993
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: