Provider Demographics
NPI:1780575225
Name:LADUE, KATHY L
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:L
Last Name:LADUE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATHY
Other - Middle Name:L
Other - Last Name:LARSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9802 DUTCH CREEK DR
Mailing Address - Street 2:
Mailing Address - City:ANAMOSA
Mailing Address - State:IA
Mailing Address - Zip Code:52205-7917
Mailing Address - Country:US
Mailing Address - Phone:319-270-5709
Mailing Address - Fax:
Practice Address - Street 1:3900 FOUNTAINS BLVD NE # 203
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52411-6610
Practice Address - Country:US
Practice Address - Phone:319-734-2002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-12
Last Update Date:2025-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program