Healthcare Provider Details

I. General information

NPI: 1609158047
Provider Name (Legal Business Name): LEOLA M CARTER APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2011
Last Update Date: 05/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7373 PERKINS RD
BATON ROUGE LA
70808-4373
US

IV. Provider business mailing address

7373 PERKINS RD
BATON ROUGE LA
70808-4373
US

V. Phone/Fax

Practice location:
  • Phone: 225-769-4044
  • Fax: 225-246-9100
Mailing address:
  • Phone: 225-246-9790
  • Fax: 225-246-9100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN075287-AP06641
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN075287
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: