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General NPI Number Information
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NPI Number | 1215253091
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Entity Type | Individual
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Provider Name | KATHERINE EAGLE LEDOUX ANP-C, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 04/19/2010
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Last Update Date | 05/16/2014
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Provider Practice Location Address
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Address Line | 2876 HIGHWAY 956
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City | ETHEL
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State | LA
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Zip | 70730-4518
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Country | US
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Telephone | 225-683-8965
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Fax |
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Provider Business Mailing Address
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Address Line | 2876 HIGHWAY 956
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City | ETHEL
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State | LA
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Zip | 70730-4518
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Country | US
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Telephone | 225-683-8965
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN093592AP06079
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | RN093592/AP06079
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN093592/AP06079
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License Number State | LA
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