Healthcare Provider Details

I. General information

NPI: 1720720089
Provider Name (Legal Business Name): KATHERINE WILLIAMS APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2022
Last Update Date: 04/10/2022
Certification Date: 04/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

527 ODD FELLOWS RD
CROWLEY LA
70526-2208
US

IV. Provider business mailing address

418 COPPER RIDGE DR
YOUNGSVILLE LA
70592-5797
US

V. Phone/Fax

Practice location:
  • Phone: 337-284-9207
  • Fax: 337-785-2016
Mailing address:
  • Phone: 337-258-9119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number224528
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: