Provider Demographics
NPI:1801110127
Name:MANUEL, CHRISTOPHER (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:
Last Name:MANUEL
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 53084
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70505-3084
Mailing Address - Country:US
Mailing Address - Phone:337-322-1245
Mailing Address - Fax:337-205-6211
Practice Address - Street 1:1300 W 8TH ST
Practice Address - Street 2:
Practice Address - City:KAPLAN
Practice Address - State:LA
Practice Address - Zip Code:70548-2916
Practice Address - Country:US
Practice Address - Phone:337-322-1245
Practice Address - Fax:337-205-6211
Is Sole Proprietor?:No
Enumeration Date:2010-03-15
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP06054363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner