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Mr. Ted Etell Fontenot, ANP
Adult Health Nurse Practitioner in Lake Charles, Louisiana
NPI 1598052052

Ted Etell Fontenot is an Adult Health Nurse Practitioner based in Dallas, LA and is specialized in Adult Health. Ted Etell Fontenot practices in Lake Charles, LA and has the professional credentials of ANP. The NPI Number for Ted Etell Fontenot is 1598052052 and holds a License No. AP06448 (Louisiana).

The current practice location address for Ted Etell Fontenot is 1717 Oak Park Blvd Fl 2, Lake Charles, LA and can be reached out via phone at 337-494-3278 and via fax at 337-494-3240. You can also correspond with Ted Etell Fontenot through the mailing address at PO BOX 122152 DEPT 2152, DALLAS, TX - 75312-0001 (mailing address contact number: 337-494-2921).

Location: 1717 Oak Park Blvd Fl 2, Lake Charles, LA, 75312-0001
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Provider Profile Details
NPI Number
1598052052
Provider Name
Ted Etell Fontenot
Credential
ANP
Provider Entity Type
Individual
Gender
Male
Address
1717 Oak Park Blvd Fl 2, Lake Charles, LA, 75312-0001
Phone Number
337-494-3278
Fax Number
337-494-3240
Provider Enumeration Date
07/06/2011
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2159445 05 LA
AP06448 01 LA STATE LICENSE
institution
Provider Business Practice Location Address Details
Address
1717 Oak Park Blvd Fl 2
City
State
Zip
70601-8990
Phone Number
337-494-3278
Fax Number
337-494-3240
person
Provider Business Mailing Address Details
Address
1717 Oak Park Blvd Fl 2
City
State
Zip
70601-8990
Phone Number
337-494-3278
Fax Number
337-494-3240
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Adult Health
Taxonomy
License No.
AP06448 (Louisiana)
Definition
Definition to come...
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