Healthcare Provider Details

I. General information

NPI: 1558940981
Provider Name (Legal Business Name): LOURDIE CHACHOUTE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LOURDIE LABBE

II. Dates (important events)

Enumeration Date: 04/04/2021
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 W UNDERWOOD ST
ORLANDO FL
32806-1110
US

IV. Provider business mailing address

16838 CORNERWOOD DR
ORLANDO FL
32820-1900
US

V. Phone/Fax

Practice location:
  • Phone: 407-841-5111
  • Fax:
Mailing address:
  • Phone: 407-919-5131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11011950
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11011950
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: