MEDICARE: MELINDA ANNE CARTER PA

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
1	363AM0700X	Medical Physician Assistant	PA 841	NV

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	V114103	OTHER	NV	SMA MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568434561
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELINDA ANNE CARTER PA

Provider Business Mailing Address
First Line	:	6471 GLEN RIVER CIR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-3051
Country	:	US
Telephone Number	:	702-301-5964
Fax Number	:

Provider Business Practice Location Address
First Line	:	6471 GLEN RIVER CIR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-3051
Country	:	US
Telephone Number	:	702-301-5964
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2006
Last Update Date	:	08/09/2016

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Directions to “ MELINDA ANNE CARTER PA” Practice Location

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