Provider Demographics
NPI:1790914497
Name:PELOQUIN, CAROL (ANP-BC)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:PELOQUIN
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17362 HIGHWAY 389
Mailing Address - Street 2:
Mailing Address - City:SINGER
Mailing Address - State:LA
Mailing Address - Zip Code:70660-3040
Mailing Address - Country:US
Mailing Address - Phone:337-786-2579
Mailing Address - Fax:
Practice Address - Street 1:17362 HIGHWAY 389
Practice Address - Street 2:
Practice Address - City:SINGER
Practice Address - State:LA
Practice Address - Zip Code:70660-3040
Practice Address - Country:US
Practice Address - Phone:337-786-2579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-02
Last Update Date:2009-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA84854-5821363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health