Provider Demographics
NPI:1689419855
Name:CARPENTER, HANNAH (FNP-C)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:764 N ACADIA RD STE A
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-5009
Mailing Address - Country:US
Mailing Address - Phone:985-446-1958
Mailing Address - Fax:985-446-0121
Practice Address - Street 1:764 N ACADIA RD STE A
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-5009
Practice Address - Country:US
Practice Address - Phone:985-446-1958
Practice Address - Fax:985-446-0121
Is Sole Proprietor?:No
Enumeration Date:2024-06-28
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA205522363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner