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Organization
KATIE PORCHE LLC
Active
Organization
KATIE PORCHE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATIE PORCHE PMHNP-BC (PRIMARY PROVIDER)
(337) 573-4132
Entity
Organization
Contact information
Practice address
814 FORTUNE RD STE 108, YOUNGSVILLE, LA 70592-5542
(337) 573-4132
(337) 573-4161
Mailing address
215 RUE FONTAINE, LAFAYETTE, LA 70508-5742
(337) 806-9339
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/30/2019
Last updated
08/28/2022
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