Provider Demographics
NPI:1932455011
Name:LABORDE, KATHRYN RAYMOND (APRN)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:RAYMOND
Last Name:LABORDE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:LYNN
Other - Last Name:RAYMOND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:611 GRAMMONT ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-7516
Mailing Address - Country:US
Mailing Address - Phone:318-325-2634
Mailing Address - Fax:318-812-1205
Practice Address - Street 1:102 THOMAS RD
Practice Address - Street 2:STE 114
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-7366
Practice Address - Country:US
Practice Address - Phone:318-812-3303
Practice Address - Fax:318-812-3304
Is Sole Proprietor?:No
Enumeration Date:2012-07-26
Last Update Date:2017-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP07046363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily