Healthcare Provider Details

I. General information

NPI: 1629485438
Provider Name (Legal Business Name): LINDSAY BROOKE CARTER NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2014
Last Update Date: 08/13/2020
Certification Date: 08/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4881 E GRANT RD STE 101
TUCSON AZ
85712-2704
US

IV. Provider business mailing address

4881 E GRANT RD STE 101
TUCSON AZ
85712-2704
US

V. Phone/Fax

Practice location:
  • Phone: 520-318-6035
  • Fax: 520-795-9953
Mailing address:
  • Phone: 520-318-6035
  • Fax: 520-318-6035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP5597
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: