Provider Demographics
NPI:1467024042
Name:LABORDE, RANDALL S II (APRN, FNP-C)
Entity Type:Individual
Prefix:MR
First Name:RANDALL
Middle Name:S
Last Name:LABORDE
Suffix:II
Gender:M
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 HIGHWAY 1188
Mailing Address - Street 2:
Mailing Address - City:HESSMER
Mailing Address - State:LA
Mailing Address - Zip Code:71341-4508
Mailing Address - Country:US
Mailing Address - Phone:318-305-3951
Mailing Address - Fax:
Practice Address - Street 1:597 TUNICA DR W
Practice Address - Street 2:
Practice Address - City:MARKSVILLE
Practice Address - State:LA
Practice Address - Zip Code:71351-2628
Practice Address - Country:US
Practice Address - Phone:318-253-0677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA221056363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily