Provider Demographics
NPI:1083927255
Name:DENET, DEJEANNE (DC)
Entity Type:Individual
Prefix:
First Name:DEJEANNE
Middle Name:
Last Name:DENET
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 790
Mailing Address - Street 2:
Mailing Address - City:BELLE CHASSE
Mailing Address - State:LA
Mailing Address - Zip Code:70037-0790
Mailing Address - Country:US
Mailing Address - Phone:504-432-1240
Mailing Address - Fax:
Practice Address - Street 1:7532 HIGHWAY 23
Practice Address - Street 2:SUITE F
Practice Address - City:BELLE CHASSE
Practice Address - State:LA
Practice Address - Zip Code:70037-1518
Practice Address - Country:US
Practice Address - Phone:504-393-2662
Practice Address - Fax:504-393-2882
Is Sole Proprietor?:No
Enumeration Date:2010-07-16
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1507111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor