MEDICARE: CORRINE CARTER

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	374U00000X	Home Health Aide	WI034371103542	WI

General Provider Information

NPI Number	:	1730849266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CORRINE CARTER

Provider Business Mailing Address
First Line	:	PO BOX 971151
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79997-1151
Country	:	US
Telephone Number	:	251-377-8213
Fax Number	:

Provider Business Practice Location Address
First Line	:	1103 CHAPMAN CIR
Second Line	:
City	:	STONE MOUNTAIN
State	:	GA
Zip	:	30088-2930
Country	:	US
Telephone Number	:	251-377-8213
Fax Number	:

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

Provider Enumeration Date	:	12/24/2021
Last Update Date	:	09/11/2025

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Directions to “ CORRINE CARTER ” Practice Location

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