Individual
CARRIE JO CEARLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6300 MAIN ST, ZACHARY, LA 70791-4037
(225) 658-4335
Mailing address
1335 E STANWICK PL, BATON ROUGE, LA 70810-2852
(214) 734-3414
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
204061
LA
207P00000X
Emergency Medicine Physician
N5611
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2120310
—
LA
Enumeration date
07/17/2007
Last updated
02/25/2013
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