Healthcare Provider Details

I. General information

NPI: 1831098706
Provider Name (Legal Business Name): RENITA ELAINE CARVER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2026
Last Update Date: 11/05/2026
Certification Date: 11/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1206 N 4TH ST
JESUP GA
31545-0912
US

IV. Provider business mailing address

1206 N 4TH ST
JESUP GA
31545-0912
US

V. Phone/Fax

Practice location:
  • Phone: 912-427-1044
  • Fax: 912-427-1048
Mailing address:
  • Phone: 912-427-1044
  • Fax: 912-427-1048

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN203203
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: