Provider Demographics
NPI:1821475815
Name:CARTER, AMESHIA (LVN)
Entity Type:Individual
Prefix:
First Name:AMESHIA
Middle Name:
Last Name:CARTER
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 ST PAUL AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-5658
Mailing Address - Country:US
Mailing Address - Phone:213-482-6400
Mailing Address - Fax:213-482-6408
Practice Address - Street 1:600 ST PAUL AVE STE 100
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-5658
Practice Address - Country:US
Practice Address - Phone:213-482-6400
Practice Address - Fax:213-482-6408
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-29
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN273725164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse