Individual
KAYLA NORDSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
401 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5864
(337) 439-0762
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
203680
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
203680
STATE LICENSE
LA
05
—
2491130
—
LA
Enumeration date
02/07/2019
Last updated
03/29/2023
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