Provider Demographics
NPI:1609116995
Name:FALCON, LAYCIE (RN)
Entity Type:Individual
Prefix:
First Name:LAYCIE
Middle Name:
Last Name:FALCON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 RUE RENOIR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-6242
Mailing Address - Country:US
Mailing Address - Phone:337-504-3283
Mailing Address - Fax:
Practice Address - Street 1:107 MONTROSE AVE
Practice Address - Street 2:SUITE D
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-3852
Practice Address - Country:US
Practice Address - Phone:337-981-9316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-22
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN117759163WN0002X
LAAP07240363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
No163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care