Provider Demographics
NPI:1598153710
Name:FLEUR DE LIS COMMUNITY HEALTH INC
Entity type:Organization
Organization Name:FLEUR DE LIS COMMUNITY HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:NEELY
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:337-668-4141
Mailing Address - Street 1:711 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:CHURCH POINT
Mailing Address - State:LA
Mailing Address - Zip Code:70525-4017
Mailing Address - Country:US
Mailing Address - Phone:337-684-0127
Mailing Address - Fax:337-684-0078
Practice Address - Street 1:711 SOUTH BROADWAY STREET
Practice Address - Street 2:
Practice Address - City:CHURCH POINT
Practice Address - State:LA
Practice Address - Zip Code:70525-4017
Practice Address - Country:US
Practice Address - Phone:337-684-0127
Practice Address - Fax:337-684-0078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-23
Last Update Date:2014-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty