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NPI Code Detail

MEDICARE: MS. KATHERINE QUAYHAGEN C-IAYT

MEDICARE: MS. KATHERINE QUAYHAGEN C-IAYT
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
1171400000XHealth & Wellness Coach67322059LA

General Provider Information

NPI Number : 1306614334
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KATHERINE QUAYHAGEN C-IAYT
Provider Business Mailing Address
First Line : 1819 CAROLINE ST
Second Line :
City : MANDEVILLE
State : LA
Zip : 70448-3804
Country : US
Telephone Number : 504-432-9934
Fax Number :
Provider Business Practice Location Address
First Line : 21516 HIGHWAY 36
Second Line :
City : ABITA SPRINGS
State : LA
Zip : 70420-3906
Country : US
Telephone Number : 504-677-8463
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2023
Last Update Date : 12/19/2023

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