Provider Demographics
NPI:1730489469
Name:DAVID, LYNNETTE FAITH (ARNP-FNP)
Entity Type:Individual
Prefix:MRS
First Name:LYNNETTE
Middle Name:FAITH
Last Name:DAVID
Suffix:
Gender:F
Credentials:ARNP-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:18989 OLD SCENIC HWY
Mailing Address - Street 2:
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791-8105
Mailing Address - Country:US
Mailing Address - Phone:225-654-6140
Mailing Address - Fax:225-654-6122
Practice Address - Street 1:4242 HIGHWAY 19 STE C
Practice Address - Street 2:
Practice Address - City:ZACHARY
Practice Address - State:LA
Practice Address - Zip Code:70791-3981
Practice Address - Country:US
Practice Address - Phone:225-654-6140
Practice Address - Fax:225-654-6122
Is Sole Proprietor?:No
Enumeration Date:2010-10-28
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN111120363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2138278Medicaid
LA2138278Medicaid