Healthcare Provider Details

I. General information

NPI: 1467181594
Provider Name (Legal Business Name): KATY GRAVES CARTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATY GRAVES

II. Dates (important events)

Enumeration Date: 06/06/2022
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HENRY CLAY AVE
NEW ORLEANS LA
70118-5720
US

IV. Provider business mailing address

200 HENRY CLAY AVE
NEW ORLEANS LA
70118-5720
US

V. Phone/Fax

Practice location:
  • Phone: 504-899-9511
  • Fax:
Mailing address:
  • Phone: 504-899-9511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number226493
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: