Kathy Jean Wales, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

053141 Issued in LA

Practice address

13964 Guy St
Walker, LA 70785-8035

Phone

(225) 939-7750

Fax

(225) 686-3082

NPI assigned

Sep 4, 2020

Last updated

Sep 4, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1599177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599177600000",
    "number": "1891309001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1130",
            "city": "LIVINGSTON",
            "state": "LA",
            "postal_code": "707541130",
            "telephone_number": "225-686-7044",
            "fax_number": "225-686-3052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13964 GUY ST",
            "city": "WALKER",
            "state": "LA",
            "postal_code": "707858035",
            "telephone_number": "225-939-7750",
            "fax_number": "225-686-3082"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Southfork Elementary",
            "address_2": "23300 Walker South Rd",
            "address_purpose": "LOCATION",
            "city": "Denham Springs",
            "state": "LA",
            "postal_code": "70726",
            "country_code": "US",
            "telephone_number": "225-664-2281",
            "fax_number": "225-664-2282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALES",
        "first_name": "KATHY",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-04",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "LA",
            "license": "053141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Nurse in Walker, LA
• Providers in Walker, LA by specialty
• Registered Nurse in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.