Provider Demographics
NPI:1881010718
Name:PERRODIN, TORI LAMSON (FNP-BC)
Entity Type:Individual
Prefix:
First Name:TORI
Middle Name:LAMSON
Last Name:PERRODIN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 AUDUBON BLVD
Mailing Address - Street 2:SUITE #102B
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-2676
Mailing Address - Country:US
Mailing Address - Phone:337-237-7801
Mailing Address - Fax:
Practice Address - Street 1:401 AUDUBON BLVD
Practice Address - Street 2:SUITE #102B
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2676
Practice Address - Country:US
Practice Address - Phone:337-237-7801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-17
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP07721363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily