Provider Demographics
NPI:1649669599
Name:FONTENOT, JOYCE J (CPMSM, CPCS)
Entity type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:J
Last Name:FONTENOT
Suffix:
Gender:F
Credentials:CPMSM, CPCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2331 POWER CENTRE PKWY
Mailing Address - Street 2:# 1302
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70607-2165
Mailing Address - Country:US
Mailing Address - Phone:337-439-9983
Mailing Address - Fax:
Practice Address - Street 1:2000 OPELOUSAS ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-2641
Practice Address - Country:US
Practice Address - Phone:337-439-9983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-15
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD00000000000OtherMEDICAL STAFF COORDINATOR