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General NPI Number Information
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NPI Number | 1588490700
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Entity Type | Individual
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Provider Name | AMBER MOUTON FNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/12/2024
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Last Update Date | 09/12/2024
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Provider Practice Location Address
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Address Line | 1314 N LAFITTE RD
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City | ABBEVILLE
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State | LA
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Zip | 70510-3149
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Country | US
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Telephone | 337-600-1121
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Fax |
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Provider Business Mailing Address
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Address Line | 116 SAN SEBASTIAN DR
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City | YOUNGSVILLE
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State | LA
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Zip | 70592-6700
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Country | US
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Telephone | 337-254-6133
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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 | 237230
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License Number State | LA
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