=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801235528
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LEE ANN CARTER APRN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/15/2013
-----------------------------------------------------
Last Update Date | 02/15/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10650 US ROUTE 60
-----------------------------------------------------
City | ASHLAND
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 41102-9611
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 606-408-6301
-----------------------------------------------------
Fax | 606-408-6350
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | P.O. BOX 1595
-----------------------------------------------------
City | ASHLAND
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 41105-1595
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 606-408-6200
-----------------------------------------------------
Fax | 606-408-6612
-----------------------------------------------------
=====================================================
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 | 3008117
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------