Provider Demographics
NPI:1427282284
Name:DAIGLE, HEATHER A (APRN, ANP-C)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:A
Last Name:DAIGLE
Suffix:
Gender:F
Credentials:APRN, ANP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 ENERGY PARKWAY
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-3816
Mailing Address - Country:US
Mailing Address - Phone:337-504-3335
Mailing Address - Fax:337-504-4795
Practice Address - Street 1:206 ENERGY PARKWAY
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-3816
Practice Address - Country:US
Practice Address - Phone:337-504-3335
Practice Address - Fax:337-504-4795
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-08
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP05777363LA2200X
LAAPO5777207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2367897Medicaid