MEDICARE: KATHARINE A CODY RN, ND, FNP-C

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	363LA2200X	Adult Health Nurse Practitioner	704317	TX
2	363LF0000X	Family Nurse Practitioner	AP113141	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801846456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHARINE A CODY RN, ND, FNP-C

Provider Business Mailing Address
First Line	:	1509 DULLES DR
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70506-3718
Country	:	US
Telephone Number	:	379-919-2763
Fax Number	:	337-943-0846

Provider Business Practice Location Address
First Line	:	8911 N CAPITAL OF TEXAS HWY STE 1110
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78759-7203
Country	:	US
Telephone Number	:	337-991-9276
Fax Number	:	337-943-0846

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

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	03/03/2023

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