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General NPI Number Information
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NPI Number | 1295395374
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Entity Type | Individual
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Provider Name | RACHELLE DUPONT ST. ANGELO FNP
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Gender | Female
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Dates
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Enumeration Date | 06/19/2019
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Last Update Date | 06/19/2019
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Provider Practice Location Address
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Address Line | 25455 HIGHWAY 1
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City | PLAQUEMINE
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State | LA
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Zip | 70764-7513
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Country | US
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Telephone | 225-754-6880
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Fax | 225-754-6885
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Provider Business Mailing Address
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Address Line | 3056 ORLEANS QUARTERS DR
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City | BRUSLY
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State | LA
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Zip | 70719-2199
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Country | US
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Telephone | 225-776-6175
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Fax |
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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 | 206497
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License Number State | LA
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