Healthcare Provider Details

I. General information

NPI: 1184542383
Provider Name (Legal Business Name): MADISON GRACE CATHEY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 HOSPITAL DR STE 460
BOSSIER CITY LA
71111-2166
US

IV. Provider business mailing address

2300 HOSPITAL DR STE 460
BOSSIER CITY LA
71111-2166
US

V. Phone/Fax

Practice location:
  • Phone: 318-212-7335
  • Fax: 318-212-7336
Mailing address:
  • Phone: 318-212-7335
  • Fax: 318-212-7336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number213112
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number213112
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: