1962117143 NPI number — MRS. BRITTANY ARLENE DYKES ST CYR FNP-BC

Table of content: MRS. BRITTANY ARLENE DYKES ST CYR FNP-BC (NPI 1962117143)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962117143 NPI number — MRS. BRITTANY ARLENE DYKES ST CYR FNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ST CYR
Provider First Name:
BRITTANY
Provider Middle Name:
ARLENE DYKES
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
FNP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1962117143
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/20/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
217 LONGLEAF DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROUSSARD
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70518-5150
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
985-981-0593
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1214 COOLIDGE BLVD
Provider Second Line Business Practice Location Address:
ATTN: BRITTANY ST CYR - PEDIATRIC UNIT
Provider Business Practice Location Address City Name:
LAFAYETTE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70503-2621
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
337-289-7991
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/20/2023

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  224615 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0200X , with the licence number: 224615 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)