Provider Demographics
NPI:1780497909
Name:PIPPIN, KATHRYN (APRN)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:PIPPIN
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 1:2998 HIGHWAY 882
Mailing Address - Street 2:
Mailing Address - City:LAKE PROVIDENCE
Mailing Address - State:LA
Mailing Address - Zip Code:71254-4333
Mailing Address - Country:US
Mailing Address - Phone:318-816-1493
Mailing Address - Fax:
Practice Address - Street 1:579 E BEOUFF ST
Practice Address - Street 2:
Practice Address - City:EUDORA
Practice Address - State:AR
Practice Address - Zip Code:71640-3090
Practice Address - Country:US
Practice Address - Phone:870-355-2512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA239716363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily