MEDICARE: KALEB CARTER

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	LG-0000904	DE
2	363LF0000X	Family Nurse Practitioner	LG-0000904	PA

General Provider Information

NPI Number	:	1538565726
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KALEB CARTER

Provider Business Mailing Address
First Line	:	17 SAWMILL RD
Second Line	:
City	:	GLEN MILLS
State	:	PA
Zip	:	19342-2270
Country	:	US
Telephone Number	:	215-264-5198
Fax Number	:

Provider Business Practice Location Address
First Line	:	2400 PHILADELPHIA PIKE
Second Line	:
City	:	CLAYMONT
State	:	DE
Zip	:	19703-2431
Country	:	US
Telephone Number	:	302-317-1531
Fax Number	:

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

Provider Enumeration Date	:	11/14/2014
Last Update Date	:	03/17/2025

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Directions to “ KALEB CARTER ” Practice Location

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