=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720218654
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TONYA M CARTER CNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/27/2009
-----------------------------------------------------
Last Update Date | 07/31/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 410 W 10TH AVE
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43210-1240
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-293-8000
-----------------------------------------------------
Fax | 614-473-0722
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2489 STELZER RD SUITE 101
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43219-3129
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-473-1300
-----------------------------------------------------
Fax | 614-473-0722
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | APRN.CNP.10807
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------