Healthcare Provider Details

I. General information

NPI: 1013485382
Provider Name (Legal Business Name): ALISHA DALILA CARTER NP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALISHA DALILA SPRINGER

II. Dates (important events)

Enumeration Date: 11/05/2018
Last Update Date: 07/07/2023
Certification Date: 07/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 INDUSTRIAL BLVD STE C
PENSACOLA FL
32503-7668
US

IV. Provider business mailing address

45 INDUSTRIAL BLVD STE C
PENSACOLA FL
32503-7668
US

V. Phone/Fax

Practice location:
  • Phone: 850-290-8410
  • Fax: 866-574-6391
Mailing address:
  • Phone: 850-290-8410
  • Fax: 866-574-6391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11014616
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberRN214915
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: