Provider Demographics
NPI:1699974832
Name:REED, KATHRYN BEAUCHAMP (CPNP-PC)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:BEAUCHAMP
Last Name:REED
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:337-470-5920
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:4707 AMBASSADOR CAFFERY PARKWAY
Practice Address - Street 2:2ND FLOOR
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508
Practice Address - Country:US
Practice Address - Phone:337-470-5920
Practice Address - Fax:855-431-6867
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP05225363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics