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General NPI Number Information
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NPI Number | 1295207058
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Entity Type | Individual
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Provider Name | OLIVIA CARTER
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Gender | Female
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Dates
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Enumeration Date | 12/18/2018
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Last Update Date | 11/05/2020
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Provider Practice Location Address
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Address Line | 55 LEXINGTON ST
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City | NEW BRITAIN
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State | CT
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Zip | 06052-1416
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Country | US
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Telephone | 860-969-4411
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Fax | 860-926-3032
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Provider Business Mailing Address
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Address Line | 213 GLEN STREET
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City | NEW BRITAIN
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State | CT
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Zip | 06051
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Country | US
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Telephone | 860-840-6054
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 8011
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License Number State | CT
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