Healthcare Provider Details

I. General information

NPI: 1609787753
Provider Name (Legal Business Name): CARLY DUHON FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1089 ELLISTON DRIVE
GONZALES LA
70737
US

IV. Provider business mailing address

1089 ELLISTON DR
GONZALES LA
70737-8269
US

V. Phone/Fax

Practice location:
  • Phone: 225-620-2928
  • Fax:
Mailing address:
  • Phone: 225-620-2928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number225815
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: