Domangue, Chad Jeremy

Domangue, Chad Jeremy is an individual health care provider with primary practice located at 1125 Marguerite St , Morgan City LA 70380-1855. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Domangue, Chad Jeremy can be contacted via phone (800) 893-9698.

Contact Information

Primary practice address
1125 Marguerite St Morgan City LA 70380-1855
Phone: (800) 893-9698
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X AP06871 Louisiana

Profile Details

NPI number 1588929723
LBN Legal business name Domangue, Chad Jeremy
Credentials NURSE PRACTITIONER
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2012
Last updated Jan 4th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588929723 NPPES
Louisiana MEDICAID 2306774

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