Provider Demographics
NPI:1932400207
Name:DARBONNE, BRANDI FONTENOT (FNP)
Entity Type:Individual
Prefix:MRS
First Name:BRANDI
Middle Name:FONTENOT
Last Name:DARBONNE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1270 ATTAKAPAS DR
Mailing Address - Street 2:SUITE 501
Mailing Address - City:OPELOUSAS
Mailing Address - State:LA
Mailing Address - Zip Code:70570-6549
Mailing Address - Country:US
Mailing Address - Phone:337-942-4453
Mailing Address - Fax:337-948-0900
Practice Address - Street 1:1270 ATTAKAPAS DR
Practice Address - Street 2:SUITE 501
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-6549
Practice Address - Country:US
Practice Address - Phone:337-942-4453
Practice Address - Fax:337-948-0900
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN105143-AP06183363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2344145Medicaid