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General NPI Number Information
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NPI Number | 1770905226
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Entity Type | Individual
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Provider Name | EBONY DOMINAQUE CARTER NP-C
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Gender | Female
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Dates
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Enumeration Date | 01/16/2014
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 3435 LEE RD
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City | SHAKER HEIGHTS
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State | OH
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Zip | 44120-3649
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Country | US
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Telephone | 216-752-9090
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Fax | 216-752-9080
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Provider Business Mailing Address
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Address Line | 3435 LEE RD
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City | SHAKER HEIGHTS
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State | OH
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Zip | 44120-3649
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Country | US
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Telephone | 216-752-9090
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Fax | 216-752-9080
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN.413108
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | APRN.CNP.0027466
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN.CNP.0027466
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | PN138244
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License Number State | OH
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