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General NPI Number Information
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NPI Number | 1093462376
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Entity Type | Individual
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Provider Name | EMILIE ANNE ADEKANBI FNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/07/2022
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 1715 WOLF CIR
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City | LAKE CHARLES
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State | LA
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Zip | 70605-2353
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Country | US
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Telephone | 337-480-7499
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Fax | 337-480-7498
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Provider Business Mailing Address
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Address Line | PO BOX 122525 DEPT 2525
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City | DALLAS
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State | TX
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Zip | 75312-2152
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Country | US
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Telephone | 337-494-2921
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Fax | 337-494-6523
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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 | 224420
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License Number State | LA
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