Provider Demographics
NPI:1982678728
Name:DAVID, CATHERINE D (FNPC)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:D
Last Name:DAVID
Suffix:
Gender:F
Credentials:FNPC
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:DERANGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNPC
Mailing Address - Street 1:9001 SUMMA AVENUE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3726
Mailing Address - Country:US
Mailing Address - Phone:225-761-5200
Mailing Address - Fax:
Practice Address - Street 1:9001 SUMMA AVENUE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3726
Practice Address - Country:US
Practice Address - Phone:225-761-5200
Practice Address - Fax:225-761-5487
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN043817363LF0000X
LAAP04579363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1477389Medicaid
3A319Medicare PIN