Healthcare Provider Details

I. General information

NPI: 1639028624
Provider Name (Legal Business Name): AUTUMN DARBONNE PLAUCHE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 OAK PARK BLVD
LAKE CHARLES LA
70601-8911
US

IV. Provider business mailing address

1701 OAK PARK BLVD
LAKE CHARLES LA
70601-8911
US

V. Phone/Fax

Practice location:
  • Phone: 337-494-2448
  • Fax:
Mailing address:
  • Phone: 337-494-2448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number226403
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number226403
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: