Healthcare Provider Details

I. General information

NPI: 1740088202
Provider Name (Legal Business Name): SYDNEY E CARTER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2025
Last Update Date: 03/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 OLIVER RD
MONROE LA
71201-5702
US

IV. Provider business mailing address

920 OLIVER RD
MONROE LA
71201-5702
US

V. Phone/Fax

Practice location:
  • Phone: 318-807-0525
  • Fax: 318-807-1077
Mailing address:
  • Phone: 318-807-0525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number211104
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: