Healthcare Provider Details

I. General information

NPI: 1346568151
Provider Name (Legal Business Name): WEEKEND CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2010
Last Update Date: 05/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1718 N FOSTER DR SUITE B
BATON ROUGE LA
70806-1017
US

IV. Provider business mailing address

PO BOX 45456
BATON ROUGE LA
70895-4456
US

V. Phone/Fax

Practice location:
  • Phone: 225-733-4559
  • Fax:
Mailing address:
  • Phone: 225-733-4559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number015344
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN075293 AP03576
License Number StateLA

VIII. Authorized Official

Name: MRS. CAROLYN LEWIS MOORE
Title or Position: FAMILY NURSE PRACTITIONER/MANAGER
Credential: EDD, FNP-B C
Phone: 225-733-4559