Organization
JOHNATHAN LARROQUETTE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHNATHAN THERON LARROQUETTE PMHNP (CERTIFIED NURSE PRACTITIONER)
(985) 247-1394
Entity
Organization
Contact information
Practice address
1214 COOLIDGE BLVD, LAFAYETTE, LA 70503-2621
(337) 289-7991
Mailing address
PO BOX 51906, LAFAYETTE, LA 70505-1906
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/11/2024
Last updated
10/09/2024
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