Provider Demographics
NPI:1063034320
Name:DJUIDJE, CARINE LAURE (PMHNP)
Entity Type:Individual
Prefix:
First Name:CARINE
Middle Name:LAURE
Last Name:DJUIDJE
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 BROWN SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-7005
Mailing Address - Country:US
Mailing Address - Phone:334-747-4159
Mailing Address - Fax:
Practice Address - Street 1:4371 NARROW LANE RD STE 205
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-2975
Practice Address - Country:US
Practice Address - Phone:334-747-7780
Practice Address - Fax:334-747-7790
Is Sole Proprietor?:No
Enumeration Date:2020-05-09
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPENDING363LP0808X
AL1-152481363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health