MEDICARE: COMMUNITY FIRST PRIMARY CARE 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	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1467309013
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY FIRST PRIMARY CARE LLC

Provider Business Mailing Address
First Line	:	30940 DUNN RD
Second Line	:
City	:	DENHAM SPRINGS
State	:	LA
Zip	:	70726-1565
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1680 BENTON LN
Second Line	:
City	:	DENHAM SPRINGS
State	:	LA
Zip	:	70726-4516
Country	:	US
Telephone Number	:	225-421-6704
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PROVIDER
Name	:	KRISTIN MANUEL
Credential	:	APRN, FNP
Telephone Number	:	225-421-6704

Provider Enumeration Date	:	03/12/2026
Last Update Date	:	03/12/2026

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