Healthcare Provider Details

I. General information

NPI: 1336277136
Provider Name (Legal Business Name): KATHERINE BASILIERE MSN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 09/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

843 MILLING AVE
LULING LA
70070-4442
US

IV. Provider business mailing address

2900 INDIANA AVENUE
KENNER LA
70065-4605
US

V. Phone/Fax

Practice location:
  • Phone: 504-575-3712
  • Fax:
Mailing address:
  • Phone: 504-575-2712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number394939
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12868
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP08479
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: