Individual
CARLOS MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
5131 ODONOVAN DR STE 100, BATON ROUGE, LA 70808-4791
(225) 767-4893
(225) 767-5494
Mailing address
5131 ODONOVAN DR STE 100, BATON ROUGE, LA 70808-4791
(225) 767-4893
(225) 767-5494
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201574
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2632124
—
LA
Enumeration date
01/17/2023
Last updated
08/12/2024
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