Provider Demographics
NPI:1649749060
Name:CARLTON, DEMETRIA D (RN)
Entity Type:Individual
Prefix:MRS
First Name:DEMETRIA
Middle Name:D
Last Name:CARLTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 CHAD LN
Mailing Address - Street 2:
Mailing Address - City:RED OAK
Mailing Address - State:TX
Mailing Address - Zip Code:75154-7609
Mailing Address - Country:US
Mailing Address - Phone:469-391-0999
Mailing Address - Fax:
Practice Address - Street 1:405 CHAD LN
Practice Address - Street 2:
Practice Address - City:RED OAK
Practice Address - State:TX
Practice Address - Zip Code:75154-7609
Practice Address - Country:US
Practice Address - Phone:469-391-0999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-14
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator