Provider Demographics
NPI:1033364922
Name:CARPENTER, ELAINE DANIEL (RN)
Entity Type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:DANIEL
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:ELEANOR
Other - Middle Name:ELAINE
Other - Last Name:CARPENTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:2605 EMILY DR
Mailing Address - Street 2:
Mailing Address - City:PORT ALLEN
Mailing Address - State:LA
Mailing Address - Zip Code:70767-5925
Mailing Address - Country:US
Mailing Address - Phone:225-226-0395
Mailing Address - Fax:
Practice Address - Street 1:2605 EMILY DR
Practice Address - Street 2:
Practice Address - City:PORT ALLEN
Practice Address - State:LA
Practice Address - Zip Code:70767-5925
Practice Address - Country:US
Practice Address - Phone:225-226-0395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-19
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA073214163WP0808X, 163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult