Provider Demographics
NPI:1245751544
Name:SEHON, CARLY SALEZ (NP)
Entity Type:Individual
Prefix:MRS
First Name:CARLY
Middle Name:SALEZ
Last Name:SEHON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:CARLY
Other - Middle Name:MARIE
Other - Last Name:SALEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:130 DESIARD ST STE 355
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-7363
Mailing Address - Country:US
Mailing Address - Phone:318-807-7875
Mailing Address - Fax:318-812-6603
Practice Address - Street 1:13348 COURSEY BLVD STE D
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-5050
Practice Address - Country:US
Practice Address - Phone:225-442-7939
Practice Address - Fax:225-777-1040
Is Sole Proprietor?:No
Enumeration Date:2017-06-28
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP09399363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily