Healthcare Provider Details

I. General information

NPI: 1841506151
Provider Name (Legal Business Name): DEBRA W. CARTER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2010
Last Update Date: 08/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 S MONROE AVE
COVINGTON VA
24426-1635
US

IV. Provider business mailing address

311 S MONROE AVE
COVINGTON VA
24426-1635
US

V. Phone/Fax

Practice location:
  • Phone: 540-965-2100
  • Fax: 540-965-2105
Mailing address:
  • Phone: 540-965-2100
  • Fax: 540-965-2105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001112045
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: