Provider Demographics
NPI:1568845493
Name:JEWELL, KATHRYN (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:JEWELL
Suffix:
Gender:F
Credentials:APRN, 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:PO BOX 368 - OAK BUILDING
Mailing Address - Street 2:
Mailing Address - City:ST FRANCISVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70775
Mailing Address - Country:US
Mailing Address - Phone:225-635-9065
Mailing Address - Fax:225-635-9069
Practice Address - Street 1:10273 GOULD DR
Practice Address - Street 2:
Practice Address - City:ST FRANCISVILLE
Practice Address - State:LA
Practice Address - Zip Code:70775-4345
Practice Address - Country:US
Practice Address - Phone:225-635-9065
Practice Address - Fax:225-635-9069
Is Sole Proprietor?:No
Enumeration Date:2015-07-09
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP08418363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner