Provider Demographics
NPI:1609504166
Name:DAIGLE, EMILY (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:DAIGLE
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:RATCLIFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:827 N UNION ST
Mailing Address - Street 2:
Mailing Address - City:OPELOUSAS
Mailing Address - State:LA
Mailing Address - Zip Code:70570-6313
Mailing Address - Country:US
Mailing Address - Phone:337-948-1802
Mailing Address - Fax:
Practice Address - Street 1:827 N UNION ST
Practice Address - Street 2:
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-6313
Practice Address - Country:US
Practice Address - Phone:337-948-1802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-11
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA226925363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA226925OtherLA STATE LICENSE