Provider Demographics
NPI:1780015974
Name:CARTER, TAMMI JOANN (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:TAMMI
Middle Name:JOANN
Last Name:CARTER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:468 ARCHAIC DR
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33880-1676
Mailing Address - Country:US
Mailing Address - Phone:863-698-0814
Mailing Address - Fax:
Practice Address - Street 1:1600 LAKELAND HILLS BLVD
Practice Address - Street 2:WATSON CLINIC
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805
Practice Address - Country:US
Practice Address - Phone:863-680-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-12
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3172402363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily