NPI Number: 1578715751
Health Care Provider/Practitioner: LISA M CARTER RPA,RTR,M,CT,RRA,RVT
Information about “1578715751” NPI (LISA M CARTER RPA,RTR,M,CT,RRA,RVT)
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<?xml version="1.0" encoding="UTF-8"?>
<Npi>
<NPI>
1578715751
</NPI>
<EntityType>
Individual
</EntityType>
<ReplacementNPI/>
<EIN/>
<IsSoleProprietor>
N
</IsSoleProprietor>
<IsOrgSubpart/>
<ParentOrgLBN/>
<ParentOrgTIN/>
<OrgName/>
<LastName>
CARTER
</LastName>
<FirstName>
LISA
</FirstName>
<MiddleName>
M
</MiddleName>
<NamePrefix/>
<NameSuffix/>
<Credential>
RPA,RTR,M,CT,RRA,RVT
</Credential>
<OtherOrgName/>
<OtherOrgNameTypeCode/>
<OtherLastName/>
<OtherFirstName/>
<OtherMiddleName/>
<OtherNamePrefix/>
<OtherNameSuffix/>
<OtherCredential/>
<OtherLastNameTypeCode/>
<FirstLineMailingAddress>
9 ARROWHEAD DR
</FirstLineMailingAddress>
<SecondLineMailingAddress/>
<MailingAddressCityName>
MARQUETTE
</MailingAddressCityName>
<MailingAddressStateName>
MI
</MailingAddressStateName>
<MailingAddressPostalCode>
49855-9456
</MailingAddressPostalCode>
<MailingAddressCountryCode>
US
</MailingAddressCountryCode>
<MailingAddressTelephoneNumber>
906-249-9804
</MailingAddressTelephoneNumber>
<MailingAddressFaxNumber/>
<FirstLinePracticeLocationAddress>
580 W COLLEGE AVE
</FirstLinePracticeLocationAddress>
<SecondLinePracticeLocationAddress/>
<PracticeLocationAddressCityName>
MARQUETTE
</PracticeLocationAddressCityName>
<PracticeLocationAddressStateName>
MI
</PracticeLocationAddressStateName>
<PracticeLocationAddressPostalCode>
49855-2705
</PracticeLocationAddressPostalCode>
<PracticeLocationAddressCountryCode>
US
</PracticeLocationAddressCountryCode>
<PracticeLocationAddressTelephoneNumber>
906-225-3540
</PracticeLocationAddressTelephoneNumber>
<PracticeLocationAddressFaxNumber/>
<EnumerationDate>
10/19/2008
</EnumerationDate>
<LastUpdateDate>
10/19/2008
</LastUpdateDate>
<NPIDeactivationReasonCode/>
<NPIDeactivationReason/>
<NPIDeactivationDate/>
<NPIReactivationDate/>
<GenderCode>
F
</GenderCode>
<Gender>
Female
</Gender>
<AuthorizedOfficialLastName/>
<AuthorizedOfficialFirstName/>
<AuthorizedOfficialMiddleName/>
<AuthorizedOfficialTitle/>
<AuthorizedOfficialNamePrefix/>
<AuthorizedOfficialNameSuffix/>
<AuthorizedOfficialCredential/>
<AuthorizedOfficialTelephoneNumber/>
<Taxonomies>
<Taxonomy>
<TaxonomyCode>
243U00000X
</TaxonomyCode>
<TaxonomyName>
Radiology Practitioner Assistant
</TaxonomyName>
<LicenseNumber/>
<LicenseNumberStateCode/>
<PrimaryTaxonomySwitch>
Y
</PrimaryTaxonomySwitch>
</Taxonomy>
<Taxonomy>
<TaxonomyCode>
246XS1301X
</TaxonomyCode>
<TaxonomyName>
Sonography Specialist/Technologist Cardiovascular
</TaxonomyName>
<LicenseNumber/>
<LicenseNumberStateCode/>
<PrimaryTaxonomySwitch>
N
</PrimaryTaxonomySwitch>
</Taxonomy>
<Taxonomy>
<TaxonomyCode>
247100000X
</TaxonomyCode>
<TaxonomyName>
Radiologic Technologist
</TaxonomyName>
<LicenseNumber/>
<LicenseNumberStateCode/>
<PrimaryTaxonomySwitch>
N
</PrimaryTaxonomySwitch>
</Taxonomy>
<Taxonomy>
<TaxonomyCode>
2471C3401X
</TaxonomyCode>
<TaxonomyName>
Computed Tomography Radiologic Technologist
</TaxonomyName>
<LicenseNumber/>
<LicenseNumberStateCode/>
<PrimaryTaxonomySwitch>
N
</PrimaryTaxonomySwitch>
</Taxonomy>
<Taxonomy>
<TaxonomyCode>
2471M2300X
</TaxonomyCode>
<TaxonomyName>
Mammography Radiologic Technologist
</TaxonomyName>
<LicenseNumber/>
<LicenseNumberStateCode/>
<PrimaryTaxonomySwitch>
N
</PrimaryTaxonomySwitch>
</Taxonomy>
<Taxonomy>
<TaxonomyCode>
2471S1302X
</TaxonomyCode>
<TaxonomyName>
Sonography Radiologic Technologist
</TaxonomyName>
<LicenseNumber/>
<LicenseNumberStateCode/>
<PrimaryTaxonomySwitch>
N
</PrimaryTaxonomySwitch>
</Taxonomy>
<Taxonomy>
<TaxonomyCode>
2471V0105X
</TaxonomyCode>
<TaxonomyName>
Vascular Sonography Radiologic Technologist
</TaxonomyName>
<LicenseNumber/>
<LicenseNumberStateCode/>
<PrimaryTaxonomySwitch>
N
</PrimaryTaxonomySwitch>
</Taxonomy>
</Taxonomies>
<HealthcareProviderTaxonomyGroups/>
</Npi>
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