Provider Demographics
NPI:1518437342
Name:CARTER, JASMINE
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:CARTER
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 1:15814 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BEACH CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77523-9379
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15814 LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:BEACH CITY
Practice Address - State:TX
Practice Address - Zip Code:77523-9379
Practice Address - Country:US
Practice Address - Phone:713-502-5285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-05
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX330904164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse