Provider Demographics
NPI:1326019258
Name:DESHOTEL, KAREN M (MSN,FNPC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:M
Last Name:DESHOTEL
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Gender:F
Credentials:MSN,FNPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:501 W SAINT MARY BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-4600
Mailing Address - Country:US
Mailing Address - Phone:337-235-7898
Mailing Address - Fax:337-235-7445
Practice Address - Street 1:501 W SAINT MARY BLVD
Practice Address - Street 2:STE 200
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-4600
Practice Address - Country:US
Practice Address - Phone:337-235-7898
Practice Address - Fax:337-235-7445
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LARN054546363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1540595Medicaid
LA1540595Medicaid
LA4B578Medicare ID - Type Unspecified