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NPI Code Detail

MEDICARE: LACY CAVALIER THOMAS FNP

MEDICARE: LACY CAVALIER THOMAS FNP
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
1363LF0000XFamily Nurse Practitioner203755LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1427615087
Entity Type Code : Individual
Provider Name (Legal Business Name) : LACY CAVALIER THOMAS FNP
Provider Business Mailing Address
First Line : PO BOX 487
Second Line :
City : SAINT FRANCISVILLE
State : LA
Zip : 70775-0487
Country : US
Telephone Number : 225-635-5848
Fax Number : 225-635-9595
Provider Business Practice Location Address
First Line : 5326 OAK ST
Second Line :
City : SAINT FRANCISVILLE
State : LA
Zip : 70775-4510
Country : US
Telephone Number : 225-635-5848
Fax Number : 225-635-9595
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2019
Last Update Date : 04/10/2025

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Directions to “ LACY CAVALIER THOMAS FNP” Practice Location

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