MEDICARE: MISS CHRISTINA D. CARPENTER ACNP-BC

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	363LA2100X	Acute Care Nurse Practitioner	17182	TN
2	363LA2100X	Acute Care Nurse Practitioner	RN123094AP07551	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619213899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS CHRISTINA D. CARPENTER ACNP-BC

Provider Business Mailing Address
First Line	:	500 RUE DE LA VIE ST STE 513
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70817-5129
Country	:	US
Telephone Number	:	225-924-8550
Fax Number	:	225-924-8647

Provider Business Practice Location Address
First Line	:	500 RUE DE LA VIE ST STE 513
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70817-5129
Country	:	US
Telephone Number	:	225-924-8550
Fax Number	:

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

Provider Enumeration Date	:	12/17/2012
Last Update Date	:	04/23/2020

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