Provider Demographics
NPI:1982837977
Name:JONES, KATY (NP)
Entity Type:Individual
Prefix:
First Name:KATY
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:MAMOU
Mailing Address - State:LA
Mailing Address - Zip Code:70554-2223
Mailing Address - Country:US
Mailing Address - Phone:337-468-2250
Mailing Address - Fax:337-468-2702
Practice Address - Street 1:805 CHERRY ST
Practice Address - Street 2:
Practice Address - City:MAMOU
Practice Address - State:LA
Practice Address - Zip Code:70554-2223
Practice Address - Country:US
Practice Address - Phone:337-468-2250
Practice Address - Fax:337-468-2702
Is Sole Proprietor?:No
Enumeration Date:2009-08-25
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP05905363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAAP05905OtherLA BOARD OF NURSING NURSE PRACTITIONER LICENSE
LA1802344Medicaid
LA3B484DL47OtherMEDICARE GROUP MEMBER PTAN