Healthcare Provider Details

I. General information

NPI: 1528787991
Provider Name (Legal Business Name): KSKM HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2022
Last Update Date: 03/06/2023
Certification Date: 03/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 BELL LN STE 4
WEST MONROE LA
71291-6303
US

IV. Provider business mailing address

PO BOX 2117
WEST MONROE LA
71294-2117
US

V. Phone/Fax

Practice location:
  • Phone: 318-310-5840
  • Fax: 318-319-2024
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KATHARIN LINDSEY
Title or Position: OWNER
Credential: FNP
Phone: 318-310-5840