| Organization Name: | DR TERRELL S MANUEL LLC |
| NPI Number: | 1003047994 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TERRELL S MANUEL (NURSE PRACTITIONER) |
| Mailing Address: | 336 Brightwood Dr Lafayette |
| State: | LA US |
| Postal Code: | 705087358 |
| Phone Number: | 3372988293 |
| Fax Number: | 3376438407 |
| NPI Enumeration Date: | 07/27/2009 |
| NPI Last Update Date: | 07/18/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | AP04812 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | LA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |