Provider Demographics
NPI:1083181457
Name:LANDRY, HEATHER DELCAMBRE (RN IBCLC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:DELCAMBRE
Last Name:LANDRY
Suffix:
Gender:F
Credentials:RN IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4833 GRANT RD
Mailing Address - Street 2:
Mailing Address - City:ERATH
Mailing Address - State:LA
Mailing Address - Zip Code:70533-5261
Mailing Address - Country:US
Mailing Address - Phone:337-523-0535
Mailing Address - Fax:
Practice Address - Street 1:4833 GRANT RD
Practice Address - Street 2:
Practice Address - City:ERATH
Practice Address - State:LA
Practice Address - Zip Code:70533-5261
Practice Address - Country:US
Practice Address - Phone:337-523-0535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-24
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN133960163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant