Provider Demographics
NPI:1730455825
Name:VIZINAT, DAVID (APRN FNP-C)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:VIZINAT
Suffix:
Gender:M
Credentials:APRN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 KATHY DR
Mailing Address - Street 2:
Mailing Address - City:RAGLEY
Mailing Address - State:LA
Mailing Address - Zip Code:70657-6613
Mailing Address - Country:US
Mailing Address - Phone:770-842-0901
Mailing Address - Fax:
Practice Address - Street 1:12186 HIGHWAY 171
Practice Address - Street 2:
Practice Address - City:LONGVILLE
Practice Address - State:LA
Practice Address - Zip Code:70652-4625
Practice Address - Country:US
Practice Address - Phone:770-842-0901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-22
Last Update Date:2017-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP08501363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily