Provider Demographics
NPI:1407495864
Name:CHAPLAIN, CAITLYN BLANCHARD (NP)
Entity Type:Individual
Prefix:
First Name:CAITLYN
Middle Name:BLANCHARD
Last Name:CHAPLAIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CAITLYN
Other - Middle Name:ALAINE
Other - Last Name:BLANCHARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6930 GENERAL DIAZ ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124-3436
Mailing Address - Country:US
Mailing Address - Phone:504-810-5965
Mailing Address - Fax:
Practice Address - Street 1:3330 W ESPLANADE AVE S STE 108
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-3454
Practice Address - Country:US
Practice Address - Phone:504-588-6900
Practice Address - Fax:504-208-5188
Is Sole Proprietor?:No
Enumeration Date:2020-01-03
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA207554207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2518429Medicaid