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NPI Code Detail

MEDICARE: KAREN BEABOUT PA-C, MPAS

MEDICARE:   KAREN  BEABOUT  PA-C, MPAS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA.200412LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
112603743OTHERCAQH
28963002OTHERCIGNA
39496680OTHERAETNA
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
560434278OTHERLAAMERIHEALTH CARITAS
62951397OTHERWELLCARE

General Provider Information

NPI Number : 1083916605
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAREN BEABOUT PA-C, MPAS
Provider Business Mailing Address
First Line : 8731 PARK PLAZA DR
Second Line :
City : SHREVEPORT
State : LA
Zip : 71105-5682
Country : US
Telephone Number : 318-797-5848
Fax Number : 318-797-5844
Provider Business Practice Location Address
First Line : 8731 PARK PLAZA DR
Second Line :
City : SHREVEPORT
State : LA
Zip : 71105-5682
Country : US
Telephone Number : 318-797-5848
Fax Number : 318-797-5844
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2010
Last Update Date : 05/19/2025

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Directions to “ KAREN BEABOUT PA-C, MPAS” Practice Location

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