Basic Information
| Provider Information | |||||||||
| NPI: | 1457451668 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CARSON | ||||||||
| FirstName: | PAIGE | ||||||||
| MiddleName: | SPENCE | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 456 FRENCH TURN ROAD | ||||||||
| Address2: | |||||||||
| City: | WINNSBORO | ||||||||
| State: | LA | ||||||||
| PostalCode: | 71295 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3184354571 | ||||||||
| FaxNumber: | 3184357458 | ||||||||
| Practice Location | |||||||||
| Address1: | 1650 DESIARD ST | ||||||||
| Address2: | |||||||||
| City: | MONROE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 712017749 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3183617370 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/25/2006 | ||||||||
| LastUpdateDate: | 01/27/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | AP05027 | LA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.