Provider Demographics
NPI:1912873167
Name:COULON, LOU CLARA
Entity type:Individual
Prefix:
First Name:LOU
Middle Name:CLARA
Last Name:COULON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1627 CAVANAUGH RD
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:KY
Mailing Address - Zip Code:42464-9304
Mailing Address - Country:US
Mailing Address - Phone:270-836-0010
Mailing Address - Fax:
Practice Address - Street 1:1627 CAVANAUGH RD
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:KY
Practice Address - Zip Code:42464-9304
Practice Address - Country:US
Practice Address - Phone:270-836-0010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-15
Last Update Date:2025-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program