Individual
MS. KATHRYN M. DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2390 W CONGRESS ST, LAFAYETTE, LA 70506-4205
(337) 261-6565
(337) 261-6568
Mailing address
2390 W CONGRESS ST, LAFAYETTE, LA 70506-4205
(337) 261-6565
(337) 261-6568
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP04288
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174459
—
LA
Enumeration date
11/30/2005
Last updated
12/09/2014
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