Healthcare Provider Details

I. General information

NPI: 1841126547
Provider Name (Legal Business Name): KAYLON ALISE PACHOLIK MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2026
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 HILLTOP DR
TROUT LA
71371-3035
US

IV. Provider business mailing address

144 HILLTOP DR
TROUT LA
71371-3035
US

V. Phone/Fax

Practice location:
  • Phone: 318-787-7566
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF06261387
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: