Healthcare Provider Details
I. General information
NPI: 1356122600
Provider Name (Legal Business Name): BLAKE TAYLOR LAGARDE APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/12/2023
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9413 BELLE CHERIE PL
NEW ORLEANS LA
70123-2633
US
IV. Provider business mailing address
9413 BELLE CHERIE PL
RIVER RIDGE LA
70123-2633
US
V. Phone/Fax
- Phone: 504-941-2881
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 239701 |
| License Number State | LA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | 239701 |
| License Number State | LA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: