MEDICARE: MR. BLAKE TAYLOR LAGARDE APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	239701	LA
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	239701	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	239701	OTHER	LA	LOUISIANA STATE BOARD OF NURSING

General Provider Information

NPI Number	:	1356122600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BLAKE TAYLOR LAGARDE APRN

Provider Business Mailing Address
First Line	:	9413 BELLE CHERIE PL
Second Line	:
City	:	RIVER RIDGE
State	:	LA
Zip	:	70123-2633
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9413 BELLE CHERIE PL
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70123-2633
Country	:	US
Telephone Number	:	504-941-2881
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2023
Last Update Date	:	12/01/2025

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