Individual
CARRIE IVERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2816 CAMBRIDGE DR, LA PLACE, LA 70068-2206
(504) 402-5641
Mailing address
2816 CAMBRIDGE DR, LA PLACE, LA 70068-2206
(504) 402-5641
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
009416037
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9373
—
LA
Enumeration date
10/05/2021
Last updated
10/05/2021
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