Healthcare Provider Details

I. General information

NPI: 1033049465
Provider Name (Legal Business Name): MS. KAYCEE CARTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KC CARTER

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11357 NUCKOLS RD # 1059
GLEN ALLEN VA
23059-5504
US

IV. Provider business mailing address

11357 NUCKOLS RD
GLEN ALLEN VA
23059-5504
US

V. Phone/Fax

Practice location:
  • Phone: 571-222-5233
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: