Provider Demographics
NPI:1538488911
Name:CARTER, CAROL L (LPN)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:L
Last Name:CARTER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:439 MCINTOSH DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-3311
Mailing Address - Country:US
Mailing Address - Phone:513-528-4483
Mailing Address - Fax:
Practice Address - Street 1:439 MCINTOSH DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-3311
Practice Address - Country:US
Practice Address - Phone:513-528-4483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-24
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN068192-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse