Provider Demographics
NPI:1811240047
Name:GUNTER, CAROL DENISE
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:DENISE
Last Name:GUNTER
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 1:1036 BRANCHVIEW DR STE 104
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-0112
Mailing Address - Country:US
Mailing Address - Phone:980-248-1900
Mailing Address - Fax:
Practice Address - Street 1:1036 BRANCHVIEW DR STE 104
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-0112
Practice Address - Country:US
Practice Address - Phone:980-248-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-25
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0002018189372500000X, 372600000X, 3747P1801X, 376K00000X
NCMH-013210385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376K00000XNursing Service Related ProvidersNurse's Aide