Provider Demographics
NPI:1215706510
Name:LAUGHLIN, DERRICK (APRN-CNP)
Entity type:Individual
Prefix:MR
First Name:DERRICK
Middle Name:
Last Name:LAUGHLIN
Suffix:
Gender:M
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3521 HIGHWAY 190 STE P
Mailing Address - Street 2:
Mailing Address - City:EUNICE
Mailing Address - State:LA
Mailing Address - Zip Code:70535-5135
Mailing Address - Country:US
Mailing Address - Phone:337-457-0745
Mailing Address - Fax:
Practice Address - Street 1:3521 HIGHWAY 190 STE P
Practice Address - Street 2:
Practice Address - City:EUNICE
Practice Address - State:LA
Practice Address - Zip Code:70535-5135
Practice Address - Country:US
Practice Address - Phone:337-457-0745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-27
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA234261363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care