Individual
MR. GLEN PAUL CARBO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
850 KALISTE SALOOM RD STE 122, LAFAYETTE, LA 70508-4230
(337) 235-9355
(337) 235-9356
Mailing address
128 BRIARMEADOW DR, LAFAYETTE, LA 70508-7210
(337) 257-2006
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN086810 AP04260
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1163619
—
LA
Enumeration date
03/20/2006
Last updated
06/30/2025
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