Healthcare Provider Details

I. General information

NPI: 1922408962
Provider Name (Legal Business Name): CARRIE T VARGAS C.R.N.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CARRIE B TURNAGE C.R.N.A.

II. Dates (important events)

Enumeration Date: 08/27/2014
Last Update Date: 02/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 W ESPLANADE AVE
KENNER LA
70065-2467
US

IV. Provider business mailing address

PO BOX 1609
HAMMOND LA
70404-1609
US

V. Phone/Fax

Practice location:
  • Phone: 504-842-3755
  • Fax: 504-842-2036
Mailing address:
  • Phone: 985-230-2198
  • Fax: 985-230-2159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP07979
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: