Provider Demographics
NPI:1174520035
Name:DOUCET, NICOLE H (NP)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:H
Last Name:DOUCET
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 S 5TH ST
Mailing Address - Street 2:
Mailing Address - City:IOTA
Mailing Address - State:LA
Mailing Address - Zip Code:70543
Mailing Address - Country:US
Mailing Address - Phone:337-779-6000
Mailing Address - Fax:
Practice Address - Street 1:119 S 5TH ST
Practice Address - Street 2:
Practice Address - City:IOTA
Practice Address - State:LA
Practice Address - Zip Code:70543-6044
Practice Address - Country:US
Practice Address - Phone:337-779-6000
Practice Address - Fax:337-779-2027
Is Sole Proprietor?:No
Enumeration Date:2005-07-06
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP04113363LW0102X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1142701Medicaid
LAP69444Medicare UPIN
LA4C426Medicare ID - Type Unspecified