Provider Demographics
NPI:1255652590
Name:CARTER, KATHERINE REED (FNP)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:REED
Last Name:CARTER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 S COTTONWOOD ST
Mailing Address - Street 2:
Mailing Address - City:BUNKIE
Mailing Address - State:LA
Mailing Address - Zip Code:71322-1135
Mailing Address - Country:US
Mailing Address - Phone:318-346-3339
Mailing Address - Fax:318-346-3337
Practice Address - Street 1:510 S COTTONWOOD ST
Practice Address - Street 2:
Practice Address - City:BUNKIE
Practice Address - State:LA
Practice Address - Zip Code:71322-1135
Practice Address - Country:US
Practice Address - Phone:318-346-3339
Practice Address - Fax:318-346-3337
Is Sole Proprietor?:No
Enumeration Date:2010-06-22
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN074817363LF0000X
LALA AP06130363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2126938Medicaid
LA2126938Medicaid