Provider Demographics
NPI:1043286834
Name:LAMBOUSY, KAREN S (NP)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:S
Last Name:LAMBOUSY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1804 LAKE SUPERIOR DR
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-5139
Mailing Address - Country:US
Mailing Address - Phone:504-905-4907
Mailing Address - Fax:504-265-9462
Practice Address - Street 1:1804 LAKE SUPERIOR DR
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-5139
Practice Address - Country:US
Practice Address - Phone:504-905-4907
Practice Address - Fax:504-265-9462
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAPO4172363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1471038Medicaid
LA4H783Medicare PIN
LAQ64007Medicare UPIN