Provider Demographics
NPI:1003854746
Name:CARDIN, JOAN P (NP)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:P
Last Name:CARDIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HOMER
Mailing Address - State:LA
Mailing Address - Zip Code:71040-3328
Mailing Address - Country:US
Mailing Address - Phone:318-927-3571
Mailing Address - Fax:318-927-2677
Practice Address - Street 1:912 W MAIN ST
Practice Address - Street 2:
Practice Address - City:HOMER
Practice Address - State:LA
Practice Address - Zip Code:71040-3328
Practice Address - Country:US
Practice Address - Phone:318-927-3571
Practice Address - Fax:318-927-2677
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP02203207P00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1692247Medicaid
LA4H5659CQ50Medicare ID - Type Unspecified
LA1692247Medicaid