Provider Demographics
NPI:1194565325
Name:LAICHE, LAUREN PECK (APRN-CNP, FNP-C)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:PECK
Last Name:LAICHE
Suffix:
Gender:F
Credentials:APRN-CNP, FNP-C
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:VIRGINIA
Other - Last Name:PECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14414 WALLY WAY
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-8470
Mailing Address - Country:US
Mailing Address - Phone:225-270-4074
Mailing Address - Fax:
Practice Address - Street 1:14414 WALLY WAY
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-8470
Practice Address - Country:US
Practice Address - Phone:225-270-4074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-27
Last Update Date:2024-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA235490363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily