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General NPI Number Information
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NPI Number | 1831960475
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Entity Type | Individual
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Provider Name | CHANDA DANIELLE BABINEAUX
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Gender | Female
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Dates
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Enumeration Date | 01/11/2024
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Last Update Date | 02/02/2024
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Provider Practice Location Address
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Address Line | 828 CRESWELL LN
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City | OPELOUSAS
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State | LA
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Zip | 70570-5882
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Country | US
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Telephone | 337-942-1802
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Fax |
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Provider Business Mailing Address
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Address Line | 501 WALTER DR
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City | LAFAYETTE
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State | LA
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Zip | 70507-2462
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Country | US
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Telephone |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 234117
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License Number State | LA
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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 | 234117
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License Number State | LA
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