Individual
MICHELLE LYNN LACOUTURE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP, PMHNP-BC
Contact information
Practice address
1225 E RIVER DR STE 205, DAVENPORT, IA 52803-5752
(563) 340-8470
Mailing address
PO BOX B, PLEASANT VALLEY, IA 52767-0401
(563) 340-8470
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
132648
IA
163W00000X
Registered Nurse
41420485
IL
163W00000X
Registered Nurse
60941765
WA
163W00000X
Registered Nurse
93013
HI
163W00000X
Registered Nurse
95164367
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
G169727
IA
Other
Enumeration date
04/05/2022
Last updated
10/05/2023
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