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General NPI Number Information
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NPI Number | 1386891687
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Entity Type | Individual
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Provider Name | DEWANNA R CHRISTIAN FNP-C
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Gender | Female
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Dates
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Enumeration Date | 08/19/2008
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Last Update Date | 08/19/2015
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Provider Practice Location Address
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Address Line | 29437 S FROST RD STE 7
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City | LIVINGSTON
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State | LA
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Zip | 70754-1910
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Country | US
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Telephone | 225-686-7555
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Fax | 225-686-2030
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Provider Business Mailing Address
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Address Line | 29437 S FROST RD STE 7
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City | LIVINGSTON
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State | LA
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Zip | 70754-1910
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Country | US
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Telephone | 225-686-7555
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Fax | 225-686-2030
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 1950
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP06169
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License Number State | LA
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