Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 023198 | LA |
Y | 208600000X | Surgeon | 023198 | LA |
N | 2086S0102X | Surgical Critical Care | 023198 | LA |
N | 2086S0127X | Trauma Surgeon | 023198 | LA |
NPI | 1326061953 |
---|---|
Provider Name | Kathryn Arlene Richardson |
First Address | Shreveport, LA 71103-4228 |
Second Address | Shreveport, LA 71103-4228 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 20/08/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1495433 | (05) | LA |
G94734 | (02) | LA |