=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194151183
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KATHERINE M CHAUVIN RN, RD, LDN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/23/2013
-----------------------------------------------------
Last Update Date | 06/18/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 39568 FLY CREEK RD
-----------------------------------------------------
City | PONCHATOULA
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70454-6824
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-329-5964
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 39568 FLY CREEK RD
-----------------------------------------------------
City | PONCHATOULA
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70454-6824
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 133V00000X
-----------------------------------------------------
Taxonomy Name | Registered Dietitian
-----------------------------------------------------
License Number | 2388
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | 210455
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------