Healthcare Provider Details

I. General information

NPI: 1457085045
Provider Name (Legal Business Name): KEVIN CARTER APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2022
Last Update Date: 07/12/2022
Certification Date: 07/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11390 MONTGOMERY RD
CINCINNATI OH
45249-2313
US

IV. Provider business mailing address

2620 ELM HILL PIKE
NASHVILLE TN
37214-3108
US

V. Phone/Fax

Practice location:
  • Phone: 513-618-4042
  • Fax:
Mailing address:
  • Phone: 615-425-4200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0031236
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: