Healthcare Provider Details

I. General information

NPI: 1598681371
Provider Name (Legal Business Name): DAWN CARTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 PROFESSIONAL CT
LAFAYETTE IN
47905-5152
US

IV. Provider business mailing address

1324 SHENANDOAH DR
LAFAYETTE IN
47905-4211
US

V. Phone/Fax

Practice location:
  • Phone: 765-756-5077
  • Fax:
Mailing address:
  • Phone: 708-369-5275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28286478C
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: