Healthcare Provider Details

I. General information

NPI: 1992613558
Provider Name (Legal Business Name): LASHONDA KIRKLIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

1106 HARGROVE ST
OAKDALE LA
71463-3425
US

IV. Provider business mailing address

1106 HARGROVE ST
OAKDALE LA
71463-3425
US

V. Phone/Fax

Practice location:
  • Phone: 318-491-3760
  • Fax:
Mailing address:
  • Phone: 318-491-3760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number211175
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: