Provider Demographics
NPI:1497754899
Name:KINCHEN, LAURIE M (CPNP,CNS)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:M
Last Name:KINCHEN
Suffix:
Gender:F
Credentials:CPNP,CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1567
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:LA
Mailing Address - Zip Code:70754-1567
Mailing Address - Country:US
Mailing Address - Phone:225-686-1114
Mailing Address - Fax:225-686-1166
Practice Address - Street 1:29565 S FROST RD STE C
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:LA
Practice Address - Zip Code:70754-1903
Practice Address - Country:US
Practice Address - Phone:225-686-1114
Practice Address - Fax:225-686-1166
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP04682363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1623156Medicaid