Provider Demographics
NPI:1215253091
Name:LEDOUX, KATHERINE EAGLE (ANP-C, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:EAGLE
Last Name:LEDOUX
Suffix:
Gender:F
Credentials:ANP-C, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2876 HIGHWAY 956
Mailing Address - Street 2:
Mailing Address - City:ETHEL
Mailing Address - State:LA
Mailing Address - Zip Code:70730-4518
Mailing Address - Country:US
Mailing Address - Phone:225-683-8965
Mailing Address - Fax:
Practice Address - Street 1:2876 HIGHWAY 956
Practice Address - Street 2:
Practice Address - City:ETHEL
Practice Address - State:LA
Practice Address - Zip Code:70730-4518
Practice Address - Country:US
Practice Address - Phone:225-683-8965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-19
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN093592AP06079363L00000X
LARN093592/AP06079363LA2200X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily