Provider Demographics
NPI:1669630497
Name:THE ARTHRITIS CLINIC INC
Entity Type:Organization
Organization Name:THE ARTHRITIS CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MIDYETT
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:318-388-5830
Mailing Address - Street 1:3402 MAGNOLIA CV
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71203-2374
Mailing Address - Country:US
Mailing Address - Phone:318-388-5830
Mailing Address - Fax:318-322-1249
Practice Address - Street 1:3402 MAGNOLIA CV
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71203-2374
Practice Address - Country:US
Practice Address - Phone:318-388-5830
Practice Address - Fax:318-322-1249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAPO4963363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty