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General NPI Number Information
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NPI Number | 1326657586
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Entity Type | Individual
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Provider Name | LEVAN ANGELLA CARTER APRN11039417
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Gender | Female
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Dates
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Enumeration Date | 07/23/2020
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Last Update Date | 09/27/2025
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Provider Practice Location Address
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Address Line | 42 DAVIN CT
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City | PONTE VEDRA BEACH
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State | FL
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Zip | 32082-1840
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Country | US
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Telephone | 904-833-3437
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Fax |
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Provider Business Mailing Address
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Address Line | 339 SW RIDGECREST DR
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34953-5918
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Country | US
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Telephone | 305-788-0005
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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 | 11039417
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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