Healthcare Provider Details

I. General information

NPI: 1770407546
Provider Name (Legal Business Name): ANNALISA D CARTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 EDGEWOOD ST NE APT 401
WASHINGTON DC
20017-3349
US

IV. Provider business mailing address

5608 SIGNET LN
RIVERDALE MD
20737-3514
US

V. Phone/Fax

Practice location:
  • Phone: 202-476-0083
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: