Healthcare Provider Details

I. General information

NPI: 1053117945
Provider Name (Legal Business Name): DANIELLE LASHAY POTTER APRN, IBCLC, CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2025
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 MURRELL ST STE 1
MINDEN LA
71055-3462
US

IV. Provider business mailing address

346 HOMER RD
MINDEN LA
71055-2834
US

V. Phone/Fax

Practice location:
  • Phone: 318-371-4052
  • Fax:
Mailing address:
  • Phone: 318-371-4052
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number217797
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: