MEDICARE: DANETTE MARIE DUVAL APRN-BC

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	363L00000X	Nurse Practitioner	AP05190	LA
2	363LA2200X	Adult Health Nurse Practitioner	RN105325 AP05190	LA

General Provider Information

NPI Number	:	1366640500
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANETTE MARIE DUVAL APRN-BC

Provider Business Mailing Address
First Line	:	500 PATTERSON ST
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70501-1849
Country	:	US
Telephone Number	:	337-769-9451
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 LA RUE FRANCE
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70508-3104
Country	:	US
Telephone Number	:	337-769-9451
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2007
Last Update Date	:	04/06/2026

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