Healthcare Provider Details

I. General information

NPI: 1629620083
Provider Name (Legal Business Name): CATIE ARNOLD GRIFFITH APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2019
Last Update Date: 03/15/2024
Certification Date: 03/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 PLANTATION HILLS BLVD
STONEWALL LA
71078
US

IV. Provider business mailing address

255 BERT KOUNS LOOP
SHREVEPORT LA
71106-8150
US

V. Phone/Fax

Practice location:
  • Phone: 318-531-8543
  • Fax: 318-591-3880
Mailing address:
  • Phone: 318-683-0411
  • Fax: 318-683-0743

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number207154
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number207154
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: