Doctor Name: | KWANZA CARTER |
NPI Number: | 1043672918 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | R199453 |
Business Practice Address: | 15604 Everglade Ln Apt 303 Bowie, MD - 207163247 |
Business Phone Number: | 9134067156 |
Business Fax Number: | |
Mailing Address: | 15604 Everglade Ln Apt 303, BOWIE |
State: | MD |
Postal Code: | 207163247 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/22/2016 |
NPI Last Update Date: | 03/22/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R199453 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |