Provider Demographics
NPI:1851934384
Name:BOUNDS, KATHY ANN (RN)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:ANN
Last Name:BOUNDS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 37
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70470-0037
Mailing Address - Country:US
Mailing Address - Phone:985-624-4100
Mailing Address - Fax:
Practice Address - Street 1:23363 S ROBIN RD
Practice Address - Street 2:
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70448-7381
Practice Address - Country:US
Practice Address - Phone:985-624-4100
Practice Address - Fax:985-624-4123
Is Sole Proprietor?:No
Enumeration Date:2019-10-28
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS856484163WA0400X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
No163W00000XNursing Service ProvidersRegistered Nurse