Healthcare Provider Details

I. General information

NPI: 1346068681
Provider Name (Legal Business Name): KATELYN PIPES HINTON PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2024
Last Update Date: 12/28/2024
Certification Date: 12/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

965 STERLINGTON HWY
FARMERVILLE LA
71241-3807
US

IV. Provider business mailing address

105 BONNABEL PL
WEST MONROE LA
71291-8181
US

V. Phone/Fax

Practice location:
  • Phone: 318-608-4681
  • Fax:
Mailing address:
  • Phone: 318-278-9023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number344608
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: