Provider Demographics
NPI:1831557024
Name:ALLEN, KATHERINE LOUISE (FNP-C)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:LOUISE
Last Name:ALLEN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25455 HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:PLAQUEMINE
Mailing Address - State:LA
Mailing Address - Zip Code:70764-7513
Mailing Address - Country:US
Mailing Address - Phone:225-754-6870
Mailing Address - Fax:225-754-6805
Practice Address - Street 1:25455 HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:PLAQUEMINE
Practice Address - State:LA
Practice Address - Zip Code:70764-7513
Practice Address - Country:US
Practice Address - Phone:885-754-6870
Practice Address - Fax:225-754-6805
Is Sole Proprietor?:No
Enumeration Date:2016-02-03
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP08665363LF0000X
CA95009933363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS03427813Medicaid
LA2410741Medicaid
LA474966YH3VMedicare PIN