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NPI Code Detail

MEDICARE: AMANDA CHARPENTIER NP

MEDICARE: AMANDA CHARPENTIER NP
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
1363LF0000XFamily Nurse Practitioner220991LA

General Provider Information

NPI Number : 1700458015
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA CHARPENTIER NP
Provider Business Mailing Address
First Line : 128 NEUROSCIENCE CT
Second Line :
City : GRAY
State : LA
Zip : 70359-5209
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 128 NEUROSCIENCE CT
Second Line :
City : GRAY
State : LA
Zip : 70359-5209
Country : US
Telephone Number : 985-917-3007
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2021
Last Update Date : 01/03/2025

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Directions to “ AMANDA CHARPENTIER NP” Practice Location

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