Provider Demographics
NPI:1356122600
Name:LAGARDE, BLAKE TAYLOR (APRN)
Entity type:Individual
Prefix:MR
First Name:BLAKE
Middle Name:TAYLOR
Last Name:LAGARDE
Suffix:
Gender:
Credentials:APRN
Other - Prefix:MR
Other - First Name:BLAKE
Other - Middle Name:T
Other - Last Name:LAGARDE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PMHNP/PCFNP-BC, DNP
Mailing Address - Street 1:9413 BELLE CHERIE PL
Mailing Address - Street 2:
Mailing Address - City:RIVER RIDGE
Mailing Address - State:LA
Mailing Address - Zip Code:70123-2633
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9413 BELLE CHERIE PL
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70123-2633
Practice Address - Country:US
Practice Address - Phone:504-941-2881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-12
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA239701363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA239701OtherLOUISIANA STATE BOARD OF NURSING