Provider Demographics
NPI:1356900716
Name:PLAISANCE, CYDNIE COOPER (NP)
Entity type:Individual
Prefix:
First Name:CYDNIE
Middle Name:COOPER
Last Name:PLAISANCE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4615 PARLIAMENT DR STE 204
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-2780
Mailing Address - Country:US
Mailing Address - Phone:318-321-5245
Mailing Address - Fax:318-542-4322
Practice Address - Street 1:4615 PARLIAMENT DR STE 204
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-2780
Practice Address - Country:US
Practice Address - Phone:318-321-5245
Practice Address - Fax:318-542-4322
Is Sole Proprietor?:No
Enumeration Date:2019-06-10
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA206212363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2536915Medicaid