Provider Demographics
NPI:1548032584
Name:CARR, THIMEKA RASHELLE (MSN)
Entity type:Individual
Prefix:
First Name:THIMEKA
Middle Name:RASHELLE
Last Name:CARR
Suffix:
Gender:F
Credentials:MSN
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 770
Mailing Address - Street 2:
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791-0770
Mailing Address - Country:US
Mailing Address - Phone:225-306-2067
Mailing Address - Fax:225-658-9443
Practice Address - Street 1:30575 OLD BATON ROUGE HWY
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-8350
Practice Address - Country:US
Practice Address - Phone:225-306-2050
Practice Address - Fax:225-567-6962
Is Sole Proprietor?:No
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA231779363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily