Provider Demographics
NPI:1437821899
Name:CARTY, CHAUNTELLE CLAUDINE
Entity Type:Individual
Prefix:
First Name:CHAUNTELLE
Middle Name:CLAUDINE
Last Name:CARTY
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 1:244 HIGH WATCH RD
Mailing Address - Street 2:
Mailing Address - City:EFFINGHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03882-8336
Mailing Address - Country:US
Mailing Address - Phone:603-831-4871
Mailing Address - Fax:
Practice Address - Street 1:244 HIGH WATCH RD
Practice Address - Street 2:
Practice Address - City:EFFINGHAM
Practice Address - State:NH
Practice Address - Zip Code:03882-8336
Practice Address - Country:US
Practice Address - Phone:603-831-4871
Practice Address - Fax:603-539-8732
Is Sole Proprietor?:No
Enumeration Date:2021-10-04
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA244446363LP0808X
NH04927923363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health