MEDICARE: SANDRA WHITE CARR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1588323034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA WHITE CARR

Provider Business Mailing Address
First Line	:	8326 KELWOOD AVE
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70806-4803
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	751 BAYOU PINES EAST DR STE C
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70601-7196
Country	:	US
Telephone Number	:	337-433-3292
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2021
Last Update Date	:	06/15/2026

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