Basic Information
| Provider Information | |||||||||
| NPI: | 1053314591 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WRIGHT | ||||||||
| FirstName: | CATHRYN | ||||||||
| MiddleName: | ELIZABETH | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 315 W FARREL RD | ||||||||
| Address2: | |||||||||
| City: | LAFAYETTE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 705087060 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3379895221 | ||||||||
| FaxNumber: | 3379849291 | ||||||||
| Practice Location | |||||||||
| Address1: | 2390 WEST CONGRESS ST | ||||||||
| Address2: | |||||||||
| City: | LAFAYETTE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 705969300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3372616000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/28/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | AP01242 | LA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 1653021 | 05 | LA | MEDICAID |