Provider Demographics
NPI:1699035790
Name:CARTER, GEORGETTE SPINNER
Entity Type:Individual
Prefix:
First Name:GEORGETTE
Middle Name:SPINNER
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 1:136 AUTUMN VIEW LN
Mailing Address - Street 2:
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:24572-6228
Mailing Address - Country:US
Mailing Address - Phone:434-661-8172
Mailing Address - Fax:
Practice Address - Street 1:136 AUTUMN VIEW LN
Practice Address - Street 2:
Practice Address - City:MADISON HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:24572-6228
Practice Address - Country:US
Practice Address - Phone:434-661-8172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-22
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1401138781374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide