Healthcare Provider Details

I. General information

NPI: 1043280860
Provider Name (Legal Business Name): JANET LEE CARTER OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 04/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5961 S LOS ALTOS PKWY STE 101
SPARKS NV
89436-2501
US

IV. Provider business mailing address

5961 S LOS ALTOS PKWY STE 101
SPARKS NV
89436-2501
US

V. Phone/Fax

Practice location:
  • Phone: 775-359-2020
  • Fax: 775-359-2676
Mailing address:
  • Phone: 775-359-2020
  • Fax: 775-359-2676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number170
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: