Healthcare Provider Details

I. General information

NPI: 1851539258
Provider Name (Legal Business Name): ROHINI B VICKNAIR PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROHINI S BERNHARD PA-C

II. Dates (important events)

Enumeration Date: 01/23/2009
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 PATTERSON ST
LAFAYETTE LA
70501-1849
US

IV. Provider business mailing address

2000 OPELOUSAS ST
LAKE CHARLES LA
70601-2641
US

V. Phone/Fax

Practice location:
  • Phone: 337-769-9451
  • Fax: 337-769-9460
Mailing address:
  • Phone: 337-439-9983
  • Fax: 337-439-8898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110002929
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number200209
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: