Provider Demographics
NPI:1710618574
Name:CARTER, JADA
Entity Type:Individual
Prefix:
First Name:JADA
Middle Name:
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 1:909 AVENUE C
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-3123
Mailing Address - Country:US
Mailing Address - Phone:504-383-7448
Mailing Address - Fax:504-946-5510
Practice Address - Street 1:909 AVENUE C
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-3123
Practice Address - Country:US
Practice Address - Phone:504-383-7448
Practice Address - Fax:504-946-5510
Is Sole Proprietor?:No
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator