MEDICARE: MRS. KATHRYN ANDERSON AGACNP

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
1	163WC0200X	Critical Care Medicine Registered Nurse	RN142939	LA
2	363LC0200X	Critical Care Medicine Nurse Practitioner	245527	LA

General Provider Information

NPI Number	:	1700742277
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATHRYN ANDERSON AGACNP

Provider Business Mailing Address
First Line	:	729 PECAN GROVE LN
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70121-1130
Country	:	US
Telephone Number	:	504-210-4472
Fax Number	:	504-210-4473

Provider Business Practice Location Address
First Line	:	1401 FOUCHER ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70115-3515
Country	:	US
Telephone Number	:	504-210-4472
Fax Number	:	504-210-4473

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/29/2025
Last Update Date	:	02/13/2026

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