Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | AP08852 | LA |
NPI | 1033560271 |
---|---|
Provider Name | Adam Carney |
First Address | Baton Rouge, LA 70815-4201 |
Second Address | Baton Rouge, LA 70815-4201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2016 |
Last Update Date | 29/06/2016 |