Provider Demographics
NPI:1316378821
Name:CARTER, BETH A (CNM & RN)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:A
Last Name:CARTER
Suffix:
Gender:F
Credentials:CNM & RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 WEST NORTH STREET
Mailing Address - Street 2:
Mailing Address - City:CORTEZ
Mailing Address - State:CO
Mailing Address - Zip Code:81321
Mailing Address - Country:US
Mailing Address - Phone:970-564-4762
Mailing Address - Fax:970-565-0647
Practice Address - Street 1:106 WEST NORTH STREET
Practice Address - Street 2:
Practice Address - City:CORTEZ
Practice Address - State:CO
Practice Address - Zip Code:81321
Practice Address - Country:US
Practice Address - Phone:970-564-4762
Practice Address - Fax:970-565-0647
Is Sole Proprietor?:No
Enumeration Date:2013-12-09
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM651367A00000X
CORN.0123515163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife