Healthcare Provider Details

I. General information

NPI: 1083986566
Provider Name (Legal Business Name): KATHRYN METREJEAN DAUZAT NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHRYN METREJEAN DAUZAT

II. Dates (important events)

Enumeration Date: 01/31/2012
Last Update Date: 04/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 4TH ST
ALEXANDRIA LA
71301-8421
US

IV. Provider business mailing address

5248 FAIRVIEW AVE
ALEXANDRIA LA
71303
US

V. Phone/Fax

Practice location:
  • Phone: 318-769-3000
  • Fax:
Mailing address:
  • Phone: 318-880-3166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF0711035
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: