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NPI Code Detail

MEDICARE: MS. KATHRYN M. DIAZ NP

MEDICARE: MS. KATHRYN M. DIAZ NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerAP04288LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1427032747
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KATHRYN M. DIAZ NP
Provider Business Mailing Address
First Line : 2390 W CONGRESS ST
Second Line :
City : LAFAYETTE
State : LA
Zip : 70506-4205
Country : US
Telephone Number : 337-261-6565
Fax Number : 337-261-6568
Provider Business Practice Location Address
First Line : 2390 W CONGRESS ST
Second Line :
City : LAFAYETTE
State : LA
Zip : 70506-4205
Country : US
Telephone Number : 337-261-6565
Fax Number : 337-261-6568
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2005
Last Update Date : 12/09/2014

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