| Type | Person | [sources] | |||
|---|---|---|---|---|---|
| Name | MARK DAMIEN JR DECLOUET · Mark DeClouet, Jr | [sources] | |||
| Birth date | [sources] | ||||
| Nationality | not available | [sources] | |||
| Country | United States | [sources] | |||
| First name | Mark | [sources] | |||
| Last name | DECLOUET · DeClouet, Jr | [sources] | |||
| Middle name | DAMIEN JR | [sources] | |||
| NPI | 1386925683 | [sources] | |||
| Sector | Nurse Practitioner | [sources] | |||
| Position | NURSE PRACTITIONER ( (IND- LIC HC SERV PRO) | [sources] | |||
| Address | 315 AUDUBON BLVD, LAFAYETTE, LA 70503 | [sources] | |||
| Last change | Last processed | First seen | |||
Medical providers excluded from Louisiana's Medicaid program.
United States · LDH
People and companies excluded from Federally funded health care programs
United States · OIG
us-fed-excl-mark-damien-jr-declouet-70503-lafayette · us-medla-96102e97189b946652fb0f766fc24ad5544cdf44For experts: raw data explorer
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| Sanctions | |||||
|---|---|---|---|---|---|
| Country | Authority | Program | Start date | End date | |
| United States | Department of Health and Human Services Office of Inspector General | - | |||
| Linked from | ||||
|---|---|---|---|---|
| Subject | Role | Start date | End date | |
| Axis Behavioral Health | Affiliated | - | - | |
| United States | Louisiana Department of Health | - | - |