Provider Demographics
NPI:1043755911
Name:VEILLON, KRISTEN D (FNP-C)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:D
Last Name:VEILLON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 JACK MILLER RD STE B
Mailing Address - Street 2:
Mailing Address - City:VILLE PLATTE
Mailing Address - State:LA
Mailing Address - Zip Code:70586-5607
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:117 W MAGNOLIA ST STE 2
Practice Address - Street 2:
Practice Address - City:BUNKIE
Practice Address - State:LA
Practice Address - Zip Code:71322-1706
Practice Address - Country:US
Practice Address - Phone:318-346-2288
Practice Address - Fax:318-346-2299
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-30
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN112206163W00000X
LAAP09108363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2515667Medicaid