Healthcare Provider Details

I. General information

NPI: 1871459404
Provider Name (Legal Business Name): KAN OPTOMETRY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2025
Last Update Date: 12/29/2025
Certification Date: 12/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 NORTHSHORE BLVD
SLIDELL LA
70460-6821
US

IV. Provider business mailing address

17403 CASTLE DR
PRAIRIEVILLE LA
70769-5200
US

V. Phone/Fax

Practice location:
  • Phone: 985-641-1331
  • Fax:
Mailing address:
  • Phone: 225-276-5825
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: KATIE ANH NGUYEN
Title or Position: OPTOMETRIST
Credential: OD
Phone: 225-276-5825