Provider Demographics
NPI:1467463794
Name:DELCAMBRE, MICHAEL-ANN BRYANT (PA-C)
Entity Type:Individual
Prefix:
First Name:MICHAEL-ANN
Middle Name:BRYANT
Last Name:DELCAMBRE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MICHAEL-ANN
Other - Middle Name:
Other - Last Name:BRYANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2745 POINT DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-2435
Mailing Address - Country:US
Mailing Address - Phone:318-512-2798
Mailing Address - Fax:
Practice Address - Street 1:309 JACKSON ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-7407
Practice Address - Country:US
Practice Address - Phone:318-966-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAA10570363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAPA.A10570OtherLOUISIANA MEDICAL LICENSE
LA5P455Medicare PIN
LAP00118127Medicare PIN