Provider Demographics
NPI:1326655499
Name:CARTER, RAEANN TERESA
Entity Type:Individual
Prefix:
First Name:RAEANN
Middle Name:TERESA
Last Name:CARTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 WHITTIER DR S APT 4
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-1448
Mailing Address - Country:US
Mailing Address - Phone:740-808-4358
Mailing Address - Fax:
Practice Address - Street 1:209 WHITTIER DR S APT 4
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-1448
Practice Address - Country:US
Practice Address - Phone:740-808-4358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-23
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist