MEDICARE: CARRIE WEBSTER MEDICAL LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	AP04957	LA

General Provider Information

NPI Number	:	1467998872
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARRIE WEBSTER MEDICAL LLC

Provider Business Mailing Address
First Line	:	PO BOX 20452
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43220-0452
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4110 PARLIAMENT DR
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71303-2717
Country	:	US
Telephone Number	:	318-880-7421
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CARRIE ANN WEBSTER
Credential	:	CRNA
Telephone Number	:	318-880-7421

Provider Enumeration Date	:	01/09/2017
Last Update Date	:	03/02/2023

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