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General NPI Number Information
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NPI Number | 1124190590
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Entity Type | Individual
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Provider Name | SHANA L CARTER MS APRN
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Gender | Female
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 2160 S 1ST AVE
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City | MAYWOOD
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State | IL
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Zip | 60153-3328
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Country | US
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Telephone | 708-216-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 320 SUNNYVIEW LN
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City | KALISPELL
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State | MT
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Zip | 59901-3129
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Country | US
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Telephone | 460-752-7441
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 120113
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209030215
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 110580
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License Number State | NE
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