1770041295 NPI number — KAREN R RUE RN-BC

Table of content: KAREN R RUE RN-BC (NPI 1770041295)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770041295 NPI number — KAREN R RUE RN-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RUE
Provider First Name:
KAREN
Provider Middle Name:
R
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RN-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1770041295
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/04/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 DECATUR AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAFAYETTE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70503-6618
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
337-280-5812
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1001 W. PINHOOK RD
Provider Second Line Business Practice Location Address:
BLDG #3, STE. 212
Provider Business Practice Location Address City Name:
LAFAYETTE, LA
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
337-988-0076
Provider Business Practice Location Address Fax Number:
337-988-7155
Provider Enumeration Date:
03/04/2019

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  RN032875 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com