Active NPI
Kaitlyn Verret Ellender
- Inpatient Obstetric Registered Nurse
- Broussard, LA
National Provider Identifier
1003684549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Inpatient Obstetric Registered Nurse
- License
- 205536
- Practice address
- 113 Spanish Moss LN
Broussard, LA 70518-7739 - Phone
- (985) 714-2181
- NPI assigned
- Dec 14, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Inpatient Obstetric Registered Nurse | 163WX0003X | 205536 | LA | Primary |
Addresses
Primary practice location
113 Spanish Moss LN
Broussard, LA 70518-7739
Mailing address
113 Spanish Moss LN
Broussard, LA 70518-7739
Phone (985) 714-2181
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 205536 | LA | MD | Inpatient Obstetric Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1702512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702512000000",
"number": "1003684549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "113 SPANISH MOSS LN",
"city": "BROUSSARD",
"state": "LA",
"postal_code": "705187739",
"telephone_number": "985-714-2181"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "113 SPANISH MOSS LN",
"city": "BROUSSARD",
"state": "LA",
"postal_code": "705187739",
"telephone_number": "985-714-2181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLENDER",
"first_name": "KAITLYN",
"middle_name": "VERRET",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-12-14",
"last_updated": "2023-12-14",
"certification_date": "2023-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "163WX0003X",
"taxonomy_group": "",
"desc": "Registered Nurse, Obstetric, Inpatient",
"state": "LA",
"license": "205536",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Broussard, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.