Provider Demographics
NPI:1598398687
Name:LACHAUD, MARJORIE (FNP)
Entity type:Individual
Prefix:
First Name:MARJORIE
Middle Name:
Last Name:LACHAUD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:MARJORIE
Other - Middle Name:
Other - Last Name:LACHAUD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:1501 FOREST HILL BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-6081
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1501 FOREST HILL BLVD STE 103
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-6081
Practice Address - Country:US
Practice Address - Phone:561-433-5090
Practice Address - Fax:561-433-1565
Is Sole Proprietor?:No
Enumeration Date:2020-02-17
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11006072363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily