Individual
MR. CLYDE LELAND DAIGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSRN, CPNP
Contact information
Practice address
100 N PRATER ST, LAKE CHARLES, LA 70601-2649
(337) 439-0886
Mailing address
201 PAYNE ST, WELSH, LA 70591-4345
(337) 734-2406
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN071430
LA
363L00000X
Nurse Practitioner
Primary
AP03189
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1532703
—
LA
Enumeration date
11/04/2008
Last updated
08/28/2015
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