Provider Demographics
NPI:1144691320
Name:CARTER, REGENIA D (APRN)
Entity type:Individual
Prefix:MRS
First Name:REGENIA
Middle Name:D
Last Name:CARTER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7495
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71211
Mailing Address - Country:US
Mailing Address - Phone:318-388-1250
Mailing Address - Fax:318-388-0948
Practice Address - Street 1:2913 DESIARD ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201
Practice Address - Country:US
Practice Address - Phone:318-651-9914
Practice Address - Fax:318-410-0688
Is Sole Proprietor?:No
Enumeration Date:2015-10-13
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA004550363LF0000X
LA224922363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARA004550OtherLICENSE NUMBER