Individual
MRS. KENDRA PAUL PATRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
4911 GROOM RD, BAKER, LA 70714-3145
(225) 454-3744
(915) 296-5612
Mailing address
3009 RAY WEILAND DR UNIT 122, BAKER, LA 70714-3251
(225) 454-3744
(915) 296-5612
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
AP07070
LA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP07070
LA
363LP2300X
Primary Care Nurse Practitioner
AP07070
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2324918
—
LA
01
—
277469YP13
MEDICARE PTAN
LA
Enumeration date
09/11/2012
Last updated
08/06/2024
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