Healthcare Provider Details

I. General information

NPI: 1649519174
Provider Name (Legal Business Name): ALEXIS CARROLL AMMONS APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2013
Last Update Date: 01/21/2026
Certification Date: 01/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 S COLLEGE RD STE 401
LAFAYETTE LA
70503-3038
US

IV. Provider business mailing address

PO BOX 2737
MONROE LA
71207-2737
US

V. Phone/Fax

Practice location:
  • Phone: 337-210-3911
  • Fax:
Mailing address:
  • Phone: 888-399-0906
  • Fax: 833-808-0833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP07188
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5010236
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP07188
License Number StateLA
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5010236
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: