Provider Demographics
NPI:1497173637
Name:LEDOUX HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:LEDOUX HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:EAGLE
Authorized Official - Last Name:LEDOUX
Authorized Official - Suffix:
Authorized Official - Credentials:ANP-C, FNP-C
Authorized Official - Phone:225-405-1176
Mailing Address - Street 1:2876 HIGHWAY 956
Mailing Address - Street 2:
Mailing Address - City:ETHEL
Mailing Address - State:LA
Mailing Address - Zip Code:70730-4518
Mailing Address - Country:US
Mailing Address - Phone:225-405-1176
Mailing Address - Fax:
Practice Address - Street 1:2876 HIGHWAY 956
Practice Address - Street 2:
Practice Address - City:ETHEL
Practice Address - State:LA
Practice Address - Zip Code:70730-4518
Practice Address - Country:US
Practice Address - Phone:225-405-1176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-04
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP06079363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty