Provider Demographics
NPI:1124517065
Name:DAVID, LAUREN DECUIR (BSN, RN, IBCLC)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:DECUIR
Last Name:DAVID
Suffix:
Gender:F
Credentials:BSN, RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 TRIPLE CROWN CIR
Mailing Address - Street 2:
Mailing Address - City:CARENCRO
Mailing Address - State:LA
Mailing Address - Zip Code:70520-4319
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:600 JEFFERSON ST STE 900
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70501-8902
Practice Address - Country:US
Practice Address - Phone:337-316-7354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-07
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN106612163WW0101X
LA11165697163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory