Healthcare Provider Details

I. General information

NPI: 1891688495
Provider Name (Legal Business Name): ZOE MADISON LACOMBE FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2025
Last Update Date: 06/02/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

431 W LAFAYETTE ST
WINNFIELD LA
71483-3463
US

IV. Provider business mailing address

148 ARCHIE DR
COLFAX LA
71417-1001
US

V. Phone/Fax

Practice location:
  • Phone: 318-648-0375
  • Fax:
Mailing address:
  • Phone: 702-354-0211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number212694
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number212694
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: