Provider Demographics
NPI:1922679448
Name:LUCIEN, KAHALA
Entity Type:Individual
Prefix:
First Name:KAHALA
Middle Name:
Last Name:LUCIEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1905 W THOMAS ST STE D386
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70401-2901
Mailing Address - Country:US
Mailing Address - Phone:985-662-0677
Mailing Address - Fax:
Practice Address - Street 1:1905 W THOMAS ST STE D386
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70401-2901
Practice Address - Country:US
Practice Address - Phone:985-662-0677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-06
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy