Organization · NPI-2

Acadiana Practitioners LLC

Clinic/Center, Rural Health · Opelousas, LA

NPI number1255809166
StatusActive
Last updated in NPPESMar 2, 2020

Details

NPI
1255809166
Entity type
Organization (NPI-2)
Legal business name
Acadiana Practitioners LLC
Organization subpart
No
Enumeration date
Nov 8, 2018
Certification date
Mar 2, 2020
Last updated
Mar 2, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QR1300X Clinic/Center, Rural Health––Yes
261Q00000X Clinic/Center––
363LF0000X Nurse Practitioner, Family––

Other names

  • Acadiana Practitioners Opelousas (Doing Business As)

Practice location

1119 Prudhomme Cir Ste F
Opelousas, LA 70570-6516

Phone 337-942-5899 · Fax 337-942-5978

Mailing address

414 Saizan Avenue
Port Barre, LA 70577

Phone 337-447-4027 · Fax 337-585-2674

Authorized official

Dustin Joseph Miller
President
3374474027

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Clinic/Center, Rural Health providers in Opelousas, LA