MEDICARE: DENNAIA CARTER RN

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	363LF0000X	Family Nurse Practitioner	R213525	MD

General Provider Information

NPI Number	:	1417667627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENNAIA CARTER RN

Provider Business Mailing Address
First Line	:	1115 CHEVRON RD
Second Line	:
City	:	SEVERN
State	:	MD
Zip	:	21144-2563
Country	:	US
Telephone Number	:	240-653-7595
Fax Number	:

Provider Business Practice Location Address
First Line	:	5397 TWIN KNOLLS RD STE 14
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21045-3256
Country	:	US
Telephone Number	:	240-391-3590
Fax Number	:

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

Provider Enumeration Date	:	11/29/2022
Last Update Date	:	12/08/2025

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Directions to “ DENNAIA CARTER RN” Practice Location

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