Provider Demographics
NPI:1467189712
Name:CARTER, JULIE KATHLINE (MSN)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:KATHLINE
Last Name:CARTER
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6720 VIA AUSTI PKWY STE
Mailing Address - Street 2:250
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-3308
Mailing Address - Country:US
Mailing Address - Phone:702-463-4050
Mailing Address - Fax:
Practice Address - Street 1:6720 VIA AUSTI PKWY STE 250
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-3568
Practice Address - Country:US
Practice Address - Phone:702-574-0480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-05
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV857589363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner