Healthcare Provider Details

I. General information

NPI: 1972457729
Provider Name (Legal Business Name): KAYLA GASPARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2026
Last Update Date: 10/11/2026
Certification Date: 10/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7406 HIGHWAY 1 STE 103
MANSURA LA
71350-4230
US

IV. Provider business mailing address

7406 HIGHWAY 1 STE 103
MANSURA LA
71350-4230
US

V. Phone/Fax

Practice location:
  • Phone: 318-739-0086
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number217852
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: