Provider Demographics
NPI:1346568151
Name:WEEKEND CARE, LLC
Entity Type:Organization
Organization Name:WEEKEND CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER/MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, FNP-B C
Authorized Official - Phone:225-733-4559
Mailing Address - Street 1:PO BOX 45456
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70895-4456
Mailing Address - Country:US
Mailing Address - Phone:225-733-4559
Mailing Address - Fax:
Practice Address - Street 1:1718 N FOSTER DR
Practice Address - Street 2:SUITE B
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-1017
Practice Address - Country:US
Practice Address - Phone:225-733-4559
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-04
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA015344207Q00000X
LARN075293 AP03576363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1317268Medicaid
LA1567981Medicaid
LA5L716CB97Medicare PIN
LA4B389C822Medicare PIN