Provider Demographics
NPI:1083916605
Name:BEABOUT, KAREN (PA-C, MPAS)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:BEABOUT
Suffix:
Gender:F
Credentials:PA-C, MPAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8731 PARK PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-5682
Mailing Address - Country:US
Mailing Address - Phone:318-797-5848
Mailing Address - Fax:318-797-5844
Practice Address - Street 1:8731 PARK PLAZA DR
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-5682
Practice Address - Country:US
Practice Address - Phone:318-797-5848
Practice Address - Fax:318-797-5844
Is Sole Proprietor?:No
Enumeration Date:2010-12-02
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPA.200412363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
9496680OtherAETNA
LA2134256Medicaid
2951397OtherWELLCARE
LA60434278OtherAMERIHEALTH CARITAS
8963002OtherCIGNA