Healthcare Provider Details

I. General information

NPI: 1477533974
Provider Name (Legal Business Name): CAROLYN J CARTER N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 11/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 FOREST GLEN RD
COLUMBUS NC
28722-3456
US

IV. Provider business mailing address

130 FOREST GLEN RD
COLUMBUS NC
28722-3456
US

V. Phone/Fax

Practice location:
  • Phone: 828-894-7000
  • Fax: 828-894-2254
Mailing address:
  • Phone: 828-894-7000
  • Fax: 828-894-2254

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3746
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number50664
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: