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General NPI Number Information
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NPI Number | 1578164935
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Entity Type | Individual
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Provider Name | MRS. SHENEESE CARTER
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Gender | Female
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Dates
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Enumeration Date | 11/03/2020
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Last Update Date | 10/19/2025
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Provider Practice Location Address
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Address Line | 1053 FARMINGTON AVE OFC 105
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City | FARMINGTON
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State | CT
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Zip | 06032-1574
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Country | US
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Telephone | 860-438-6844
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Fax |
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Provider Business Mailing Address
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Address Line | 1053 FARMINGTON AVE OFC 105
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City | FARMINGTON
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State | CT
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Zip | 06032-1574
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Country | US
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Telephone | 860-438-6844
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Fax | 949-222-6591
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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 | 9319
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License Number State | CT
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