Provider Demographics
NPI:1538331806
Name:CARPENTER, KATIE WEBSTER (DC)
Entity Type:Individual
Prefix:DR
First Name:KATIE
Middle Name:WEBSTER
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:KATIE
Other - Middle Name:LYNN
Other - Last Name:WEBSTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:3441 E CAUSEWAY APPROACH
Mailing Address - Street 2:SUITE D
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70448-3480
Mailing Address - Country:US
Mailing Address - Phone:985-626-0999
Mailing Address - Fax:985-626-0089
Practice Address - Street 1:3441 E CAUSEWAY APPROACH
Practice Address - Street 2:SUITE D
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70448-3480
Practice Address - Country:US
Practice Address - Phone:985-626-0999
Practice Address - Fax:985-626-0089
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-27
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1450111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor