=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720902521
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KAREN O CARTER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/05/2026
-----------------------------------------------------
Last Update Date | 08/05/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 635 N MAIN ST STE 687
-----------------------------------------------------
City | RICHFIELD
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84701-1895
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 435-274-7080
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2246 N SR 118
-----------------------------------------------------
City | MONROE
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84754-3506
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 801-368-6926
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084B0040X
-----------------------------------------------------
Taxonomy Name | Behavioral Neurology & Neuropsychiatry Physician
-----------------------------------------------------
License Number | 191140-4405
-----------------------------------------------------
License Number State | UT
-----------------------------------------------------