Provider Demographics
NPI:1356951602
Name:PRUDHOMME, CHARLOTTE DUPUY (RN)
Entity type:Individual
Prefix:MRS
First Name:CHARLOTTE
Middle Name:DUPUY
Last Name:PRUDHOMME
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24145 COATS RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:LA
Mailing Address - Zip Code:70462-8119
Mailing Address - Country:US
Mailing Address - Phone:225-294-3306
Mailing Address - Fax:
Practice Address - Street 1:24145 COATS RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:LA
Practice Address - Zip Code:70462-8119
Practice Address - Country:US
Practice Address - Phone:225-294-3306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-02
Last Update Date:2020-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN089942163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool