Provider Demographics
NPI:1760743058
Name:BYRNE, LACI HUCKABY (APRN, ANP)
Entity Type:Individual
Prefix:MRS
First Name:LACI
Middle Name:HUCKABY
Last Name:BYRNE
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Gender:F
Credentials:APRN, ANP
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Mailing Address - Street 1:1322 ELTON RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:JENNINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70546-4100
Mailing Address - Country:US
Mailing Address - Phone:337-824-8868
Mailing Address - Fax:337-824-8840
Practice Address - Street 1:1322 ELTON RD
Practice Address - Street 2:SUITE F
Practice Address - City:JENNINGS
Practice Address - State:LA
Practice Address - Zip Code:70546-4100
Practice Address - Country:US
Practice Address - Phone:337-824-8868
Practice Address - Fax:337-824-8840
Is Sole Proprietor?:No
Enumeration Date:2012-06-03
Last Update Date:2016-06-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LAAP06820363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2336801Medicaid
LA315177YJ8UMedicare PIN