Provider Demographics
NPI:1518742345
Name:CARTER, DONTIA RENEE
Entity Type:Individual
Prefix:
First Name:DONTIA
Middle Name:RENEE
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 1:2220 WESTWOOD NORTHERN BLVD APT B27
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45225-1422
Mailing Address - Country:US
Mailing Address - Phone:513-814-8915
Mailing Address - Fax:
Practice Address - Street 1:2220 WESTWOOD NORTHERN BLVD APT B27
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45225-1422
Practice Address - Country:US
Practice Address - Phone:513-814-8915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3654216374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide