Provider Demographics
NPI:1346582475
Name:CARTER CLINICAL SERVICES, INC
Entity Type:Organization
Organization Name:CARTER CLINICAL SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN, FNP-BC, CWO
Authorized Official - Phone:731-394-3499
Mailing Address - Street 1:PO BOX 93
Mailing Address - Street 2:
Mailing Address - City:YORKVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38389-0093
Mailing Address - Country:US
Mailing Address - Phone:731-394-3499
Mailing Address - Fax:877-287-2007
Practice Address - Street 1:40 BOND CEMETERY RD
Practice Address - Street 2:
Practice Address - City:DENMARK
Practice Address - State:TN
Practice Address - Zip Code:38391-2066
Practice Address - Country:US
Practice Address - Phone:731-394-3499
Practice Address - Fax:877-287-2007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-27
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6510363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty