Individual
KATY JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
805 CHERRY ST, MAMOU, LA 70554-2223
(337) 468-2250
(337) 468-2702
Mailing address
805 CHERRY ST, MAMOU, LA 70554-2223
(337) 468-2250
(337) 468-2702
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
AP05905
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1802344
—
LA
01
—
3B484DL47
MEDICARE GROUP MEMBER PTAN
LA
01
—
AP05905
LA BOARD OF NURSING NURSE PRACTITIONER LICENSE
LA
Enumeration date
08/25/2009
Last updated
04/07/2010
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