Healthcare Provider Details

I. General information

NPI: 1679039606
Provider Name (Legal Business Name): JACQUELINE CHOATE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JACQUELINE WHITE

II. Dates (important events)

Enumeration Date: 02/14/2019
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1214 COOLIDGE BLVD
LAFAYETTE LA
70503-2621
US

IV. Provider business mailing address

311 ARTISAN RD APT G
LAFAYETTE LA
70508-5854
US

V. Phone/Fax

Practice location:
  • Phone: 337-289-7740
  • Fax:
Mailing address:
  • Phone: 337-254-2526
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number203678
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number203678
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number203678
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: