Healthcare Provider Details

I. General information

NPI: 1194655050
Provider Name (Legal Business Name): LESLEY CARR FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1633 MARVEL ST
COUSHATTA LA
71019-9022
US

IV. Provider business mailing address

1633 MARVEL ST
COUSHATTA LA
71019-9022
US

V. Phone/Fax

Practice location:
  • Phone: 318-932-2170
  • Fax: 318-932-2242
Mailing address:
  • Phone: 318-932-2170
  • Fax: 318-932-2242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number246703
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: