Provider Demographics
NPI:1194062125
Name:MARCANTEL, ANNA L (APRN FNP-C)
Entity type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:L
Last Name:MARCANTEL
Suffix:
Gender:F
Credentials:APRN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 123594
Mailing Address - Street 2:DEPT 3594
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75312-3594
Mailing Address - Country:US
Mailing Address - Phone:337-494-2919
Mailing Address - Fax:337-494-3069
Practice Address - Street 1:1420 18TH ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-7646
Practice Address - Country:US
Practice Address - Phone:337-562-0510
Practice Address - Fax:337-562-0810
Is Sole Proprietor?:No
Enumeration Date:2013-01-10
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAPO7133363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily