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General NPI Number Information
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NPI Number | 1548564644
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Entity Type | Organization
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Legal Business Name | PRO-NP LLC
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Dates
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Enumeration Date | 01/04/2011
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Last Update Date | 08/13/2024
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Provider Practice Location Address
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Address Line | 325 BACQUE CRESCENT DR
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City | LAFAYETTE
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State | LA
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Zip | 70503-2842
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Country | US
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Telephone | 337-207-0528
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Fax | 337-205-6211
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Provider Business Mailing Address
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Address Line | PO BOX 53084
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City | LAFAYETTE
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State | LA
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Zip | 70505-3084
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Country | US
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Telephone | 337-207-0528
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Fax | 337-205-6211
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Authorized Official
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Title or Position | NP/OWNER
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Name | MR. CHRISTOPHER J MANUEL
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Credential | NP
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Telephone | 337-322-1245
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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