Provider Demographics
NPI:1407123961
Name:PIERPONT, CARLA M (FNP)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:M
Last Name:PIERPONT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:CARLA MICHALLE
Other - Middle Name:LESLIE
Other - Last Name:PIERPONT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:PO BOX 184
Mailing Address - Street 2:
Mailing Address - City:GAUTIER
Mailing Address - State:MS
Mailing Address - Zip Code:39553-0184
Mailing Address - Country:US
Mailing Address - Phone:228-990-8810
Mailing Address - Fax:
Practice Address - Street 1:150 REYNOIR ST
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39530-4130
Practice Address - Country:US
Practice Address - Phone:228-436-1191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-28
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS845619363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily