Healthcare Provider Details

I. General information

NPI: 1003776329
Provider Name (Legal Business Name): DEANN CARPENTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2025
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

690 SAN ANTONIO AVE
MANY LA
71449-3015
US

IV. Provider business mailing address

194 RAY CARPENTER RD
NATCHITOCHES LA
71457-7734
US

V. Phone/Fax

Practice location:
  • Phone: 318-256-5200
  • Fax:
Mailing address:
  • Phone: 318-951-3483
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: