Provider Demographics
NPI:1083903066
Name:LAVERGNE, KAREN P (RN, IBCLC, RLC)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:P
Last Name:LAVERGNE
Suffix:
Gender:F
Credentials:RN, IBCLC, RLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 INDIGO DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70507-3137
Mailing Address - Country:US
Mailing Address - Phone:337-886-2615
Mailing Address - Fax:
Practice Address - Street 1:204 INDIGO DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70507-3137
Practice Address - Country:US
Practice Address - Phone:337-886-2615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-30
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN097632163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant