Healthcare Provider Details

I. General information

NPI: 1255652590
Provider Name (Legal Business Name): KATHERINE REED CARTER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2010
Last Update Date: 02/01/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 S COTTONWOOD ST
BUNKIE LA
71322-1135
US

IV. Provider business mailing address

510 S COTTONWOOD ST
BUNKIE LA
71322-1135
US

V. Phone/Fax

Practice location:
  • Phone: 318-346-3339
  • Fax: 318-346-3337
Mailing address:
  • Phone: 318-346-3339
  • Fax: 318-346-3337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN074817
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLA AP06130
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: