Provider Demographics
NPI:1245939784
Name:LAVIGNE, CASSIE HENDERSON (APRN-NNP-BC)
Entity type:Individual
Prefix:MRS
First Name:CASSIE
Middle Name:HENDERSON
Last Name:LAVIGNE
Suffix:
Gender:F
Credentials:APRN-NNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7701 NORTON AVE
Mailing Address - Street 2:
Mailing Address - City:HARAHAN
Mailing Address - State:LA
Mailing Address - Zip Code:70123-4520
Mailing Address - Country:US
Mailing Address - Phone:504-701-5844
Mailing Address - Fax:
Practice Address - Street 1:4700 S I 10 SERVICE RD W
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-1210
Practice Address - Country:US
Practice Address - Phone:504-780-4583
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA229513363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care