Healthcare Provider Details

I. General information

NPI: 1215286711
Provider Name (Legal Business Name): NATHAN LEIGH CARTER NP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2012
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5147 N 9TH AVE STE 103
PENSACOLA FL
32504-8770
US

IV. Provider business mailing address

PO BOX 2699
PENSACOLA FL
32513-2699
US

V. Phone/Fax

Practice location:
  • Phone: 850-494-9000
  • Fax: 850-416-1911
Mailing address:
  • Phone: 850-475-4500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9467096
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: