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NPI Code Detail

MEDICARE: DAJOURNEE FONTENETTE

MEDICARE:   DAJOURNEE  FONTENETTE
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
1172V00000XCommunity Health Worker
2374U00000XHome Health Aide

General Provider Information

NPI Number : 1720858095
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAJOURNEE FONTENETTE
Provider Business Mailing Address
First Line : 5858 PINEWOOD DR W
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70607-7578
Country : US
Telephone Number : 337-680-8410
Fax Number :
Provider Business Practice Location Address
First Line : 5858 PINEWOOD DR W
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70607-7578
Country : US
Telephone Number : 337-680-8410
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2024
Last Update Date : 01/08/2024

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Directions to “ DAJOURNEE FONTENETTE ” Practice Location

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