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NPI Code Detail

MEDICARE: CHARLESTINE CARTER CRNA

MEDICARE: CHARLESTINE CARTER CRNA
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
1367500000XCertified Registered Nurse AnesthetistR794408MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346286499
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLESTINE CARTER CRNA
Provider Business Mailing Address
First Line : PO BOX 2106
Second Line :
City : MERIDIAN
State : MS
Zip : 39302-2106
Country : US
Telephone Number : 601-703-9506
Fax Number : 601-703-3264
Provider Business Practice Location Address
First Line : 25117 HIGHWAY 15
Second Line :
City : UNION
State : MS
Zip : 39365-9088
Country : US
Telephone Number : 601-774-8214
Fax Number : 601-774-8379
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2006
Last Update Date : 11/16/2011

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Directions to “ CHARLESTINE CARTER CRNA” Practice Location

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