MEDICARE: MRS. GLANDNAIR CATHERINE CARTER NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	VP005661C	PA

General Provider Information

NPI Number	:	1295794295
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. GLANDNAIR CATHERINE CARTER NP

Provider Business Mailing Address
First Line	:	250 W PASTORIUS ST
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19144-3202
Country	:	US
Telephone Number	:	215-843-5314
Fax Number	:	215-843-5314

Provider Business Practice Location Address
First Line	:	FORT INDIANTOWN GAP BLDG 4-115
Second Line	:
City	:	ANNVILLE
State	:	PA
Zip	:	17003-5002
Country	:	US
Telephone Number	:	717-861-2769
Fax Number	:	717-861-2637

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2006
Last Update Date	:	07/08/2007

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