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General NPI Number Information
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NPI Number | 1033592886
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Entity Type | Individual
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Provider Name | DARCI PORTIE NP
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Gender | Female
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Dates
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Enumeration Date | 06/29/2015
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Last Update Date | 09/01/2021
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Provider Practice Location Address
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Address Line | 803 W BAYOU PINES DR STE B
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City | LAKE CHARLES
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State | LA
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Zip | 70601-7096
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Country | US
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Telephone | 337-508-2333
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Fax | 337-549-6316
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Provider Business Mailing Address
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Address Line | 803 W BAYOU PINES DR STE B
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City | LAKE CHARLES
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State | LA
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Zip | 70601-7096
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Country | US
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Telephone | 337-508-2333
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Fax | 337-549-6316
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP08424
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License Number State | LA
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