Provider Demographics
NPI:1134595622
Name:GOLLA, KAREN LYNN (FNP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:LYNN
Last Name:GOLLA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:LYNN
Other - Last Name:HOFFPAUIR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:422 KADE DR STE 1
Mailing Address - Street 2:
Mailing Address - City:JENNINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70546-3657
Mailing Address - Country:US
Mailing Address - Phone:337-388-6200
Mailing Address - Fax:337-388-6201
Practice Address - Street 1:422 KADE DR STE 1
Practice Address - Street 2:
Practice Address - City:JENNINGS
Practice Address - State:LA
Practice Address - Zip Code:70546
Practice Address - Country:US
Practice Address - Phone:337-388-6200
Practice Address - Fax:337-388-6201
Is Sole Proprietor?:No
Enumeration Date:2015-08-19
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP08316363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily