Provider Demographics
NPI:1942676911
Name:PERKINS, KATHERINE L (APRN)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:L
Last Name:PERKINS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 INDEPENDENCE BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791-7390
Mailing Address - Country:US
Mailing Address - Phone:225-376-2128
Mailing Address - Fax:866-493-3436
Practice Address - Street 1:1215 INDEPENDENCE BLVD STE B
Practice Address - Street 2:
Practice Address - City:ZACHARY
Practice Address - State:LA
Practice Address - Zip Code:70791-7390
Practice Address - Country:US
Practice Address - Phone:225-376-2128
Practice Address - Fax:866-493-3436
Is Sole Proprietor?:No
Enumeration Date:2015-08-13
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP082232084P0800X, 363LP0200X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2403605Medicaid
LA2403605Medicaid
LA447995YH3VMedicare PIN