Provider Demographics
NPI:1053117952
Name:BARHAM, CARRIE J (CNP)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:J
Last Name:BARHAM
Suffix:
Gender:
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1407 HIGHWAY 115
Mailing Address - Street 2:
Mailing Address - City:DEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71328-9297
Mailing Address - Country:US
Mailing Address - Phone:318-564-9449
Mailing Address - Fax:
Practice Address - Street 1:3330 MASONIC DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-3841
Practice Address - Country:US
Practice Address - Phone:318-466-6010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-21
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA239689363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health