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General NPI Number Information
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NPI Number | 1336935618
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Entity Type | Organization
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Legal Business Name | CABUCK COMMUNITY CLINIC
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Dates
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Enumeration Date | 04/15/2025
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Last Update Date | 02/17/2026
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Provider Practice Location Address
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Address Line | 13 CABUCK LN
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City | RAYVILLE
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State | LA
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Zip | 71269-7402
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Country | US
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Telephone | 318-303-4019
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Fax | 318-303-4184
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Provider Business Mailing Address
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Address Line | 13 CABUCK LN
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City | RAYVILLE
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State | LA
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Zip | 71269-7402
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Country | US
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Telephone | 318-303-4019
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Fax | 318-303-4184
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. KIMBERLY ANDREWS
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Credential | RN
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Telephone | 318-303-4019
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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