Individual
JERELYN CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2495 SHREVEPORT HWY, PINEVILLE, LA 71360-4044
(318) 473-0010
Mailing address
1920 BRENTWOOD AVE, ALEXANDRIA, LA 71301-3801
(337) 424-3253
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
123733
LA
Other
Enumeration date
08/03/2017
Last updated
08/03/2017
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