Provider Demographics
NPI:1043326556
Name:CARTER, SHERRIE L (WHNP)
Entity Type:Individual
Prefix:
First Name:SHERRIE
Middle Name:L
Last Name:CARTER
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3370 S TEXAS AVE # B
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-3127
Mailing Address - Country:US
Mailing Address - Phone:979-595-1700
Mailing Address - Fax:979-595-1740
Practice Address - Street 1:3370 S TEXAS AVE # B
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-3127
Practice Address - Country:US
Practice Address - Phone:979-595-1700
Practice Address - Fax:979-595-1740
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX534712363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX534712OtherTEX STATE BOARD/NURSING
TX451942Medicare ID - Type UnspecifiedFQHC MEDICARE