Provider Demographics
NPI:1508597246
Name:CARR, EKAETTE R
Entity Type:Individual
Prefix:MS
First Name:EKAETTE
Middle Name:R
Last Name:CARR
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 1:3190 S VAUGHN WAY STE 550
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-3538
Mailing Address - Country:US
Mailing Address - Phone:720-296-7027
Mailing Address - Fax:303-432-9921
Practice Address - Street 1:3190 S VAUGHN WAY STE 550
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-3538
Practice Address - Country:US
Practice Address - Phone:720-296-7027
Practice Address - Fax:303-432-9921
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty