Healthcare Provider Details

I. General information

NPI: 1790295400
Provider Name (Legal Business Name): APRIL CARTER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2017
Last Update Date: 10/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2941 TERRY RD
JACKSON MS
39212-3073
US

IV. Provider business mailing address

291 COLEMAN RD
BRANDON MS
39042-9528
US

V. Phone/Fax

Practice location:
  • Phone: 601-373-0566
  • Fax:
Mailing address:
  • Phone: 601-503-4213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LS0200X
TaxonomySchool Nurse Practitioner
License Number902295
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number902295
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: