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NPI Code Detail

MEDICARE: KRISTY L CARTER PA-C

MEDICARE: KRISTY L CARTER PA-C
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
1363A00000XPhysician Assistant50.005531RXOH
2363AS0400XSurgical Physician Assistant10001055AIN

General Provider Information

NPI Number : 1386881456
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTY L CARTER PA-C
Provider Business Mailing Address
First Line : 1100 REID PARKWAY
Second Line : MEDICAL STAFF SERVICES
City : RICHMOND
State : IN
Zip : 47374-1157
Country : US
Telephone Number : 765-966-1600
Fax Number : 765-983-3219
Provider Business Practice Location Address
First Line : 1434 CHESTER BLVD
Second Line :
City : RICHMOND
State : IN
Zip : 47374-1947
Country : US
Telephone Number : 765-966-1600
Fax Number : 765-962-9641
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2009
Last Update Date : 05/12/2021

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Directions to “ KRISTY L CARTER PA-C” Practice Location

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