Provider Demographics
NPI:1376155044
Name:CARTER, JOAN M (NP)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:M
Last Name:CARTER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JOAN
Other - Middle Name:M
Other - Last Name:MARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 PARK HILL DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-3357
Mailing Address - Country:US
Mailing Address - Phone:540-287-4178
Mailing Address - Fax:
Practice Address - Street 1:10718 BALLANTRAYE DR STE 406
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-4703
Practice Address - Country:US
Practice Address - Phone:540-834-2320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-23
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001228947163W00000X
VA0024180471363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse