Provider Demographics
NPI:1760835128
Name:CARRIERE, WAYNE DARREN JR
Entity Type:Individual
Prefix:MR
First Name:WAYNE
Middle Name:DARREN
Last Name:CARRIERE
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4859 LANCELOT DRIVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70127
Mailing Address - Country:US
Mailing Address - Phone:504-304-2929
Mailing Address - Fax:
Practice Address - Street 1:2439 MANHATTAN BLVD STE 308
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-5396
Practice Address - Country:US
Practice Address - Phone:504-366-5265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-20
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator