MEDICARE: CHRIS JAMES DEMENT A.N.P.

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	363LA2200X	Adult Health Nurse Practitioner	AP03367	LA

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	:	1699750422
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRIS JAMES DEMENT A.N.P.

Provider Business Mailing Address
First Line	:	5959 S SHERWOOD FOREST BLVD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-6038
Country	:	US
Telephone Number	:	318-966-1550
Fax Number	:

Provider Business Practice Location Address
First Line	:	2807 MARK DR
Second Line	:
City	:	MONROE
State	:	LA
Zip	:	71201-5152
Country	:	US
Telephone Number	:	318-966-1550
Fax Number	:	318-966-1552

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

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	09/23/2025

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