Provider Demographics
NPI:1730626912
Name:CAILLOUET, LACHELLE NICOLE (RN, FNP-C)
Entity type:Individual
Prefix:
First Name:LACHELLE
Middle Name:NICOLE
Last Name:CAILLOUET
Suffix:
Gender:F
Credentials:RN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 HOSPITAL DR STE 115
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77701-4633
Mailing Address - Country:US
Mailing Address - Phone:409-838-4533
Mailing Address - Fax:
Practice Address - Street 1:810 HOSPITAL DR STE 115
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-4633
Practice Address - Country:US
Practice Address - Phone:409-838-4533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-25
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP133083363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily