Provider Demographics
NPI:1659139855
Name:CARTER, HEATHER MICHELLE
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:MICHELLE
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 1:420 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CAIRO
Mailing Address - State:OH
Mailing Address - Zip Code:45820-6517
Mailing Address - Country:US
Mailing Address - Phone:419-615-2742
Mailing Address - Fax:
Practice Address - Street 1:420 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CAIRO
Practice Address - State:OH
Practice Address - Zip Code:45820-6517
Practice Address - Country:US
Practice Address - Phone:419-615-2742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide