Healthcare Provider Details

I. General information

NPI: 1225827108
Provider Name (Legal Business Name): ALEXIS BRIANNA CARTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2025
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 HOSPITAL DR
MONROE NC
28112-6000
US

IV. Provider business mailing address

143 FIRESTONE CT
SELLERS SC
29592-8009
US

V. Phone/Fax

Practice location:
  • Phone: 980-993-3100
  • Fax:
Mailing address:
  • Phone: 843-627-1888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-16153
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: