Provider Demographics
NPI:1831340132
Name:CARTER, JOSSELIN AGUILAR (PA)
Entity type:Individual
Prefix:
First Name:JOSSELIN
Middle Name:AGUILAR
Last Name:CARTER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:JOSSELIN
Other - Middle Name:PATRICIA
Other - Last Name:AGUILAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:225-526-0001
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:7777 HENNESSY BLVD
Practice Address - Street 2:SUITE 1000
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4300
Practice Address - Country:US
Practice Address - Phone:225-767-3900
Practice Address - Fax:225-766-2226
Is Sole Proprietor?:No
Enumeration Date:2008-10-05
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA200198363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS02972394Medicaid
LA1383040Medicaid
LA1383040Medicaid
5DS29PE32Medicare PIN