Provider Demographics
NPI:1780392530
Name:COMYNE, CHARLENA (RN, BSN)
Entity type:Individual
Prefix:MRS
First Name:CHARLENA
Middle Name:
Last Name:COMYNE
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:343 CAMUS RD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-6322
Mailing Address - Country:US
Mailing Address - Phone:337-739-5459
Mailing Address - Fax:
Practice Address - Street 1:600 FOREMAN DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-5331
Practice Address - Country:US
Practice Address - Phone:337-521-7750
Practice Address - Fax:337-521-7751
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-10
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN109046163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool