Provider Demographics
NPI:1164741369
Name:CARLTON, PATRICIA R (NP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:R
Last Name:CARLTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4320 BRAMBLETON AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-3405
Mailing Address - Country:US
Mailing Address - Phone:540-725-7546
Mailing Address - Fax:540-725-9741
Practice Address - Street 1:4320 BRAMBLETON AVE
Practice Address - Street 2:SUITE B
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-3405
Practice Address - Country:US
Practice Address - Phone:540-725-7546
Practice Address - Fax:540-725-9741
Is Sole Proprietor?:No
Enumeration Date:2010-05-27
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0024102809363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner