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General NPI Number Information
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NPI Number | 1851023634
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Entity Type | Individual
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Provider Name | NANCY DIANE CARTER FNP
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Gender | Female
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Dates
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Enumeration Date | 06/29/2022
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Last Update Date | 06/29/2022
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Provider Practice Location Address
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Address Line | 3753 W SURI RISE LN # J103
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City | HERRIMAN
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State | UT
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Zip | 84096-2426
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Country | US
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Telephone | 435-421-1303
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Fax |
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Provider Business Mailing Address
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Address Line | 3753 WEST SURI RISE LANE UNIT #J103 P.O. BOX 129
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City | HERRIMAN
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State | UT
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Zip | 84096
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Country | US
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Telephone | 435-421-1303
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 202195-4405
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License Number State | UT
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