Provider Demographics
NPI:1326672890
Name:CARTER, ANGELA RENA (A-GNP-C)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:RENA
Last Name:CARTER
Suffix:
Gender:F
Credentials:A-GNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4019 LONGWAY ESTATES CT
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:TX
Mailing Address - Zip Code:77545-8646
Mailing Address - Country:US
Mailing Address - Phone:713-444-5116
Mailing Address - Fax:
Practice Address - Street 1:4019 LONGWAY ESTATES CT
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:TX
Practice Address - Zip Code:77545-8646
Practice Address - Country:US
Practice Address - Phone:713-444-5116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-24
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP144955363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology