Healthcare Provider Details

I. General information

NPI: 1144691320
Provider Name (Legal Business Name): REGENIA D CARTER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2015
Last Update Date: 09/08/2022
Certification Date: 09/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2913 DESIARD ST
MONROE LA
71201
US

IV. Provider business mailing address

PO BOX 7495
MONROE LA
71211
US

V. Phone/Fax

Practice location:
  • Phone: 318-651-9914
  • Fax: 318-410-0688
Mailing address:
  • Phone: 318-388-1250
  • Fax: 318-388-0948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA004550
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number224922
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: