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General NPI Number Information
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NPI Number | 1770941841
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Entity Type | Individual
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Provider Name | CARRIE MARIE UMBERGER PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/04/2016
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Last Update Date | 12/17/2020
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Provider Practice Location Address
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Address Line | 1441 OCHSNER BLVD
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City | COVINGTON
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State | LA
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Zip | 70433-8110
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Country | US
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Telephone | 985-400-5551
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Fax | 985-400-5428
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Provider Business Mailing Address
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Address Line | 1441 OCHSNER BLVD
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City | COVINGTON
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State | LA
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Zip | 70433-8110
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Country | US
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Telephone | 985-400-5551
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Fax | 985-400-5428
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 324102
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2459
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License Number State | SC
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