Provider Demographics
NPI:1699329516
Name:BLANCHARD, CAROLINE (NP)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:BLANCHARD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5215 ESSEN LN STE 200
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3543
Mailing Address - Country:US
Mailing Address - Phone:225-215-1281
Mailing Address - Fax:225-215-1380
Practice Address - Street 1:2800 VETERANS MEMORIAL BLVD STE 140
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-6139
Practice Address - Country:US
Practice Address - Phone:225-767-0847
Practice Address - Fax:225-215-1380
Is Sole Proprietor?:No
Enumeration Date:2019-07-29
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA206919363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2509381Medicaid