Healthcare Provider Details

I. General information

NPI: 1679469548
Provider Name (Legal Business Name): KATHRYN ELISE OGEA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2025
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1514 JEFFERSON HWY
JEFFERSON LA
70121-2429
US

IV. Provider business mailing address

210 W 10TH AVE
COVINGTON LA
70433-3643
US

V. Phone/Fax

Practice location:
  • Phone: 504-842-3000
  • Fax:
Mailing address:
  • Phone: 985-502-0314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number212771
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: