Provider Demographics
NPI:1376268714
Name:LAFITTE, AUDRA LOUISE (RN, APRN, AGPCNP-BC)
Entity Type:Individual
Prefix:MS
First Name:AUDRA
Middle Name:LOUISE
Last Name:LAFITTE
Suffix:
Gender:F
Credentials:RN, APRN, AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6409 STONEY CREEK DR
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77503-1133
Mailing Address - Country:US
Mailing Address - Phone:713-254-8082
Mailing Address - Fax:
Practice Address - Street 1:6409 STONEY CREEK DR
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77503-1133
Practice Address - Country:US
Practice Address - Phone:713-254-8082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-07
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1089647363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner