Healthcare Provider Details

I. General information

NPI: 1326966706
Provider Name (Legal Business Name): LAUREN POCHE AGUILLARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 BERTRAND DR
LAFAYETTE LA
70506-4110
US

IV. Provider business mailing address

107 COLONIAL DR
LAFAYETTE LA
70506-3229
US

V. Phone/Fax

Practice location:
  • Phone: 866-624-7637
  • Fax:
Mailing address:
  • Phone: 337-459-7935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number202962
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: