Healthcare Provider Details

I. General information

NPI: 1730976515
Provider Name (Legal Business Name): PATRICIA MICHOT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2025
Last Update Date: 04/23/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2375 COULEE CROSSING RD
WOODWORTH LA
71485-9713
US

IV. Provider business mailing address

2375 COULEE CROSSING RD
WOODWORTH LA
71485-9713
US

V. Phone/Fax

Practice location:
  • Phone: 318-715-7155
  • Fax:
Mailing address:
  • Phone: 318-715-7155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0000X
TaxonomyPain Management Registered Nurse
License NumberRN089850
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: