Healthcare Provider Details

I. General information

NPI: 1487353637
Provider Name (Legal Business Name): KATIE LAHAYE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2023
Last Update Date: 02/27/2023
Certification Date: 07/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

524 DR MICHAEL DEBAKEY DR
LAKE CHARLES LA
70601-5725
US

IV. Provider business mailing address

PO BOX 846039
DALLAS TX
75284-6039
US

V. Phone/Fax

Practice location:
  • Phone: 337-436-2511
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number228930
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number228930
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number228930
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: