Provider Demographics
NPI:1043280860
Name:CARTER, JANET LEE (OD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:LEE
Last Name:CARTER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5961 S LOS ALTOS PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89436-2501
Mailing Address - Country:US
Mailing Address - Phone:775-359-2020
Mailing Address - Fax:775-359-2676
Practice Address - Street 1:5961 S LOS ALTOS PKWY STE 101
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89436-2501
Practice Address - Country:US
Practice Address - Phone:775-359-2020
Practice Address - Fax:775-359-2676
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV170152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1043280860Medicaid
NV1225343965Medicaid
NV1033212030Medicaid
NV1033212030Medicaid