Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | AP05793 | LA |
N | 363LP0200X | Nurse Practitioner - Pediatrics | AP05793 | LA |
NPI | 1306071162 |
---|---|
Provider Name | Amy Arceneaux Vitte |
First Address | Baton Rouge, LA 70816-6038 |
Second Address | Lafayette, LA 70508-6908 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2009 |
Last Update Date | 17/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1883891 | (05) | LA |