Provider Demographics
NPI:1558962845
Name:MANN, PATTY (NP)
Entity Type:Individual
Prefix:
First Name:PATTY
Middle Name:
Last Name:MANN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:PATTY
Other - Middle Name:
Other - Last Name:FLOYD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1509 DULLES DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-3718
Mailing Address - Country:US
Mailing Address - Phone:337-981-9295
Mailing Address - Fax:337-981-9296
Practice Address - Street 1:1509 DULLES DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-3718
Practice Address - Country:US
Practice Address - Phone:337-981-9295
Practice Address - Fax:337-981-9296
Is Sole Proprietor?:No
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-104218363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily