Healthcare Provider Details

I. General information

NPI: 1700388956
Provider Name (Legal Business Name): BRANDI KAY CARTER FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2018
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 PARKWOOD DR
ELKIN NC
28621
US

IV. Provider business mailing address

1942 SWAN CREEK RD
HAMPTONVILLE NC
27020-8307
US

V. Phone/Fax

Practice location:
  • Phone: 336-830-3321
  • Fax:
Mailing address:
  • Phone: 336-830-3321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number239947
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5010826
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: