Provider Demographics
NPI:1598907297
Name:HARPER, NICOLE PINO (MD)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:PINO
Last Name:HARPER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 HEYMANN BLVD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-2616
Mailing Address - Country:US
Mailing Address - Phone:337-234-3344
Mailing Address - Fax:337-234-3352
Practice Address - Street 1:435 HEYMANN BLVD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2616
Practice Address - Country:US
Practice Address - Phone:337-234-3344
Practice Address - Fax:337-234-3352
Is Sole Proprietor?:No
Enumeration Date:2009-03-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.206054207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA206054OtherLICENSE
LA043121OtherCDS
LA1965073Medicaid
LA1659688489OtherGROUP NPI
LA304417YJOAOtherMEDICARE GRP MEMBER PTAN
LA304417YJOAOtherMEDICARE GRP MEMBER PTAN