Provider Demographics
NPI:1689962730
Name:DIONNE, DAVID ALLEN (MSN, CNOR,ANP)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ALLEN
Last Name:DIONNE
Suffix:
Gender:M
Credentials:MSN, CNOR,ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71192 HIGHWAY 21 STE 100
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-7161
Mailing Address - Country:US
Mailing Address - Phone:985-871-6020
Mailing Address - Fax:985-898-7977
Practice Address - Street 1:71192 HWY 21, STE 100
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433
Practice Address - Country:US
Practice Address - Phone:985-871-6020
Practice Address - Fax:985-898-7977
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LATAP002648363LA2200X
LAAP06696363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2176099Medicaid