Healthcare Provider Details

I. General information

NPI: 1346343621
Provider Name (Legal Business Name): KATHY ANN BRIEGER LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIT 6, MEADOW LANE RRTC CENTRAL STATE HOSPITAL
PINEVILLE LA
71306
US

IV. Provider business mailing address

5712 SKYE ST
ALEXANDRIA LA
71303-3939
US

V. Phone/Fax

Practice location:
  • Phone: 318-484-6402
  • Fax: 318-487-5703
Mailing address:
  • Phone: 318-473-9154
  • Fax: 318-487-5703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number771305
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: