Provider Demographics
NPI:1659723856
Name:CARTER, MARTIN WESLEY (CRNP)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:WESLEY
Last Name:CARTER
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1855 SPRING HILL AVE
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36607-2301
Mailing Address - Country:US
Mailing Address - Phone:251-471-3544
Mailing Address - Fax:251-476-7456
Practice Address - Street 1:1855 SPRING HILL AVE
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36607-2301
Practice Address - Country:US
Practice Address - Phone:251-471-3544
Practice Address - Fax:251-476-7456
Is Sole Proprietor?:No
Enumeration Date:2016-07-12
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-116761363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily