Healthcare Provider Details

I. General information

NPI: 1306703236
Provider Name (Legal Business Name): EMMANUELLA CARTER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2026
Last Update Date: 01/05/2026
Certification Date: 12/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 SE CENTRAL PKWY
STUART FL
34994-5905
US

IV. Provider business mailing address

400 39TH CT SW
VERO BEACH FL
32968-3936
US

V. Phone/Fax

Practice location:
  • Phone: 561-452-4347
  • Fax:
Mailing address:
  • Phone: 561-452-4347
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11044461
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: