MEDICARE: DR TERRELL S MANUEL LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP04812	LA
2	363LF0000X	Family Nurse Practitioner

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003047994
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR TERRELL S MANUEL LLC

Provider Business Mailing Address
First Line	:	336 BRIGHTWOOD DR
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70508-7358
Country	:	US
Telephone Number	:	337-298-8293
Fax Number	:

Provider Business Practice Location Address
First Line	:	12038 GREENWELL SPRINGS PORT HUDSON ROAD
Second Line	:
City	:	ZACHARY
State	:	LA
Zip	:	70791
Country	:	US
Telephone Number	:	225-654-1560
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PROVIDER
Name	:	TERRELL S MANUEL
Credential	:	FNP, PMHNP, DNP
Telephone Number	:	337-298-8293

Provider Enumeration Date	:	07/27/2009
Last Update Date	:	06/11/2026

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Directions to “DR TERRELL S MANUEL LLC ” Practice Location

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