Provider Demographics
NPI:1881131266
Name:SEGURA, KRISTIN (APRN, NP)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:SEGURA
Suffix:
Gender:F
Credentials:APRN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2829 4TH AVE
Mailing Address - Street 2:STE 150
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-7897
Mailing Address - Country:US
Mailing Address - Phone:337-477-7091
Mailing Address - Fax:337-474-4552
Practice Address - Street 1:2802 HODGES ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-7368
Practice Address - Country:US
Practice Address - Phone:337-419-1873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-24
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP09085363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health