Provider Demographics
NPI:1770056301
Name:FONTENOT, ANGELA RENEE (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:RENEE
Last Name:FONTENOT
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:196 WILD IRIS DR
Mailing Address - Street 2:
Mailing Address - City:EVANGELINE
Mailing Address - State:LA
Mailing Address - Zip Code:70537-3203
Mailing Address - Country:US
Mailing Address - Phone:337-250-2000
Mailing Address - Fax:337-616-9399
Practice Address - Street 1:901 HUGH WALLIS RD S
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508
Practice Address - Country:US
Practice Address - Phone:337-250-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-07
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA202446363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily