Provider Demographics
NPI:1497955215
Name:CARTER, ERICKA ELIZABETH (PA - C)
Entity Type:Individual
Prefix:MISS
First Name:ERICKA
Middle Name:ELIZABETH
Last Name:CARTER
Suffix:
Gender:F
Credentials:PA - C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3787 SHIPYARD BLVD, WILMINGTON
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-6148
Mailing Address - Country:US
Mailing Address - Phone:910-332-3800
Mailing Address - Fax:
Practice Address - Street 1:3787 SHIPYARD BLVD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-6148
Practice Address - Country:US
Practice Address - Phone:910-332-3800
Practice Address - Fax:910-251-0421
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1750363A00000X
WV01276363A00000X
OH50002428363A00000X
NC0010-10374363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1450PAMedicaid
SCP01051845OtherRR MEDICARE
SCAA85892221OtherMEDICARE PTAN