Provider Demographics
NPI:1558970335
Name:VERRET, KADIE
Entity Type:Individual
Prefix:
First Name:KADIE
Middle Name:
Last Name:VERRET
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1634 ELTON RD
Mailing Address - Street 2:
Mailing Address - City:JENNINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70546-3614
Mailing Address - Country:US
Mailing Address - Phone:337-616-7000
Mailing Address - Fax:337-616-7034
Practice Address - Street 1:328 KELLOGG AVE
Practice Address - Street 2:
Practice Address - City:LAKE ARTHUR
Practice Address - State:LA
Practice Address - Zip Code:70549-4116
Practice Address - Country:US
Practice Address - Phone:337-774-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-28
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA214529363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily