Provider Demographics
NPI:1548424864
Name:CARTER, LASHONDA (NP)
Entity Type:Individual
Prefix:
First Name:LASHONDA
Middle Name:
Last Name:CARTER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 870263
Mailing Address - Street 2:
Mailing Address - City:MORROW
Mailing Address - State:GA
Mailing Address - Zip Code:30287-0263
Mailing Address - Country:US
Mailing Address - Phone:678-463-1588
Mailing Address - Fax:
Practice Address - Street 1:6220 CLAYTS CIR
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31216-5403
Practice Address - Country:US
Practice Address - Phone:678-463-1588
Practice Address - Fax:678-463-1588
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-16
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN135688NP163W00000X
GARN135688363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse