Provider Demographics
NPI:1871075358
Name:EUGENE, KAREN YVETTE
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:YVETTE
Last Name:EUGENE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9212 EIGHTY ARPENT RD
Mailing Address - Street 2:
Mailing Address - City:JEANERETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70544-7003
Mailing Address - Country:US
Mailing Address - Phone:337-241-5094
Mailing Address - Fax:
Practice Address - Street 1:825 CENTER ST
Practice Address - Street 2:
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70560-5500
Practice Address - Country:US
Practice Address - Phone:225-819-7228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-31
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA171M00000XOtherCASE MANAGER