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General NPI Number Information
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NPI Number | 1831775030
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Entity Type | Individual
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Provider Name | KRISTEN TANIA CARTER LPTA
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Gender | Female
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Dates
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Enumeration Date | 03/19/2021
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Last Update Date | 03/19/2021
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Provider Practice Location Address
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Address Line | 680 BAY COVE DR
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City | BILOXI
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State | MS
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Zip | 39532-5551
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Country | US
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Telephone | 228-702-0142
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Fax | 228-396-3060
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Provider Business Mailing Address
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Address Line | 3200 N 6TH ST
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-8419
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Country | US
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Telephone | 601-394-9845
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PTA5801
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License Number State | MS
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