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General NPI Number Information
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NPI Number | 1437830858
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Entity Type | Individual
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Provider Name | JONI K ACCLIS
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Gender | Female
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Dates
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Enumeration Date | 07/27/2023
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Last Update Date | 05/23/2024
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Provider Practice Location Address
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Address Line | 3983 I 49 S SERVICE RD
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City | OPELOUSAS
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State | LA
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Zip | 70570-0758
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Country | US
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Telephone | 337-678-4856
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Fax | 337-594-1290
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Provider Business Mailing Address
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Address Line | 204 RUE ENVIE
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City | CARENCRO
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State | LA
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Zip | 70520-4030
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Country | US
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Telephone | 225-341-9723
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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 | F07230589
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License Number State | LA
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