Provider Demographics
NPI:1215413513
Name:CARTER, KATHERINE FRIDEL (CPNP-BC)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:FRIDEL
Last Name:CARTER
Suffix:
Gender:F
Credentials:CPNP-BC
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:MARY
Other - Last Name:FRIDEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPNP-BC
Mailing Address - Street 1:601 CHILDRENS LN DEPT OF
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23507-1910
Mailing Address - Country:US
Mailing Address - Phone:757-668-7244
Mailing Address - Fax:757-668-9814
Practice Address - Street 1:601 CHILDRENS LN
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1910
Practice Address - Country:US
Practice Address - Phone:757-668-7244
Practice Address - Fax:757-668-9814
Is Sole Proprietor?:No
Enumeration Date:2018-07-19
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024176313363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics