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NPI Code Detail

MEDICARE: MRS. SHANA L CARTER MS APRN

MEDICARE: MRS. SHANA L CARTER MS APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner120113MT
2363LF0000XFamily Nurse Practitioner209030215IL
3363LF0000XFamily Nurse Practitioner110580NE

General Provider Information

NPI Number : 1124190590
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SHANA L CARTER MS APRN
Provider Business Mailing Address
First Line : 320 SUNNYVIEW LN
Second Line :
City : KALISPELL
State : MT
Zip : 59901-3129
Country : US
Telephone Number : 460-752-7441
Fax Number :
Provider Business Practice Location Address
First Line : 2160 S 1ST AVE
Second Line :
City : MAYWOOD
State : IL
Zip : 60153-3328
Country : US
Telephone Number : 708-216-9000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2006
Last Update Date : 12/03/2025

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