MR. GLEN PAUL CARBO (NPI# 1598724585) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598724585 |
| Entity Type | Individual |
| Full Name | MR. GLEN PAUL CARBO |
| Credential | F.N.P. |
| Practice Address |
850 Kaliste Saloom Rd Ste 122 Lafayette LA 70508-4230 |
| Mailing Address |
850 Kaliste Saloom Rd Ste 122 Lafayette LA 70508-4230 |
| Practice Telephone | 3372359355 |
| Practice Fax Number | 3372359356 |
| Mailing Telephone | 3372359355 |
| Mailing Fax Number | 3372359356 |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2019-07-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN086810 AP04260 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1163619 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5000 Ambassador Caffery Pkwy, Building 1, Lafayette, LA 70508 | 3372610928 | 3372375173 |
| Street Address |
850 KALISTE SALOOM RD STE 122 |
| City | LAFAYETTE |
| State | LA |
| Zip Code | 70508-4230 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215596531 | Eleanor Hebert Bourque | Nurse Practitioner | 850 Kaliste Saloom Rd Ste 122, Lafayette, LA 70508-4230 | 2019-06-10 |
| 1790275717 | Raquel Antoinette Mccorvey | Nurse Practitioner | 850 Kaliste Saloom Rd Ste 122, Lafayette, LA 70508-4230 | 2018-05-15 |
| 1790226611 | Checkup, LLC | Clinic/Center | 850 Kaliste Saloom Rd Ste 122, Lafayette, LA 70508-4230 | 2017-03-10 |
| 1932406832 | Christy Elaine Lee | Nurse Practitioner | 850 Kaliste Saloom Rd Ste 122, Lafayette, LA 70508-4230 | 2011-02-12 |
| 1740508316 | Johnica Ann Hebert | Nurse Practitioner | 850 Kaliste Saloom Rd Ste 122, Lafayette, LA 70508-4230 | 2010-05-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346868676 | Cypress Bend Oral & Maxillofacial Surgery | Dentist | 106 Rue Bastille, Lafayette, LA 70508 | 2020-07-13 |
| 1184250607 | Learning Grove Therapy LLC | Clinic/Center | 105 Anaheim Lane, Lafayette, LA 70508 | 2020-03-16 |
| 1780218727 | Jennifer Trumps | Case Manager/Care Coordinator | 200 Entergy Parkway, Lafayette, LA 70508 | 2020-02-28 |
| 1740749605 | Hunter Sy Arceneaux | Physical Therapist | 1700 Kaliste Saloom Road, Building 3, Suite 300, Lafayette, LA 70508 | 2019-03-19 |
| 1295292787 | Brad Michael Gros | Counselor | 160 South Beadle Road, Lafayette, LA 70508 | 2019-02-21 |
| 1205337581 | Alternative Perspectives, LLC | Clinic/Center | 2807 Kaliste Saloom Rd Ste B, Lafayette, LA 70508 | 2018-02-22 |
| 1124528807 | Zachariah James Hebert | Counselor | 1602 W Pinhook Rd Suite 100a, The Family Tree, Lafayette, LA 70508 | 2018-02-19 |
| 1164934477 | Ilyas Munshi, Md Apmc | Non-Pharmacy Dispensing Site | 99 W. Martial Ave, Lafayette, LA 70508 | 2017-10-26 |
| 1447761226 | Louisiana Orthopaedic Specialists, LLC | Durable Medical Equipment & Medical Supplies | 4231 Ambassador Caffery Pkwy, Suite 102, Lafayette, LA 70508 | 2017-10-19 |
| 1306365457 | Mk Dixon Counseling and Consulting | Counselor | 105 Industrial Parkway, Lafayette, LA 70508 | 2017-09-10 |
| Find all providers in zip 70508 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952915233 | Christi Danielle Carmouche | Nurse Practitioner | 119 Crooked Stick Ln, Lafayette, LA 70506-7539 | 2020-09-03 |
| 1881204808 | Shavondali Harris Cawthorne | Nurse Practitioner | 945 Bellevue Plantation Rd, Lafayette, LA 70503-6122 | 2020-08-04 |
| 1386253870 | Millcreek Medical LLC | Nurse Practitioner | 105 Moss Brook Dr, Lafayette, LA 70508-8039 | 2020-07-30 |
| 1174145759 | Synita Wooten | Nurse Practitioner | 200 Highway 52 Byp E, Lafayette, TN 37083-1353 | 2020-05-18 |
| 1316567548 | Michelle Cataldo | Nurse Practitioner | 605 Viridian Dr Apt 148, Lafayette, CO 80026-7045 | 2020-04-17 |
| 1255974515 | Dr. Terrell S Manuel, LLC | Nurse Practitioner | 336 Brightwood Dr, Lafayette, LA 70508-7358 | 2019-10-19 |
| 1477117562 | Kayley Jon Myers | Nurse Practitioner | 200 Beaullieu Dr Ste 6, Lafayette, LA 70508-7230 | 2019-04-24 |
| 1003371840 | Brandi Rene Boutte | Nurse Practitioner | 1101 Kaliste Saloom Rd Ste 304, Lafayette, LA 70508-5705 | 2019-02-06 |
| 1265912141 | Kathryn Lynn Armentor Boutte | Nurse Practitioner | 4212 W Congress St Ste 3300, Lafayette, LA 70506-6789 | 2018-08-20 |
| 1801380829 | Sarah Darouse | Nurse Practitioner | 155 Hospital Dr Ste 101, Lafayette, LA 70503-2852 | 2018-06-22 |
| Find all providers in LAFAYETTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.