Provider Demographics
NPI:1225638737
Name:DPDNP, LLC
Entity Type:Organization
Organization Name:DPDNP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:PHILIP
Authorized Official - Last Name:DENICOLA
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:504-914-7889
Mailing Address - Street 1:1264 AVENUE DU CHATEAU
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-6423
Mailing Address - Country:US
Mailing Address - Phone:504-914-7889
Mailing Address - Fax:
Practice Address - Street 1:1264 AVENUE DU CHATEAU
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-6423
Practice Address - Country:US
Practice Address - Phone:504-914-7889
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty