Provider Demographics
NPI:1326040452
Name:CARTER, KAREN HENARD (DC)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:HENARD
Last Name:CARTER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:KAREN
Other - Middle Name:SUE
Other - Last Name:HENARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:4566 E HIGHWAY 20
Mailing Address - Street 2:STE 205
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-8839
Mailing Address - Country:US
Mailing Address - Phone:850-897-1105
Mailing Address - Fax:850-897-1108
Practice Address - Street 1:4566 E HIGHWAY 20
Practice Address - Street 2:STE 205
Practice Address - City:NICEVILLE
Practice Address - State:FL
Practice Address - Zip Code:32578-8839
Practice Address - Country:US
Practice Address - Phone:850-897-1105
Practice Address - Fax:850-897-1108
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-01
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7913111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381265100Medicaid
FL381265100Medicaid
FL55958Medicare ID - Type Unspecified