Provider Demographics
NPI:1083986566
Name:DAUZAT, KATHRYN METREJEAN (NP-C)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:METREJEAN
Last Name:DAUZAT
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:METREJEAN
Other - Last Name:DAUZAT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:5248 FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303
Mailing Address - Country:US
Mailing Address - Phone:318-880-3166
Mailing Address - Fax:
Practice Address - Street 1:211 4TH ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-8421
Practice Address - Country:US
Practice Address - Phone:318-769-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-31
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAF0711035363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily