Healthcare Provider Details

I. General information

NPI: 1346430261
Provider Name (Legal Business Name): KATHERINE POIRRIER SPEARS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2007
Last Update Date: 09/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 SAINT JOHN ST
LAFAYETTE LA
70501-6711
US

IV. Provider business mailing address

713 N AVENUE L
CROWLEY LA
70526-3832
US

V. Phone/Fax

Practice location:
  • Phone: 337-269-5000
  • Fax: 337-269-5001
Mailing address:
  • Phone: 337-788-3330
  • Fax: 337-788-4770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberAP05206
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN096944
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: