Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD.205401 | LA |
N | 111NI0900X | Internist | MD.205401 | LA |
Y | 207RI0200X | Infectious Disease | 34246 | AL |
NPI | 1073812871 |
---|---|
Provider Name | Katherine Wiltz Lavie |
First Address | Baton Rouge, LA 70808-9136 |
Second Address | Baton Rouge, LA 70808-9153 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2011 |
Last Update Date | 22/09/2021 |