Provider Demographics
NPI:1841568490
Name:CARTER, EUNICE (CHP)
Entity Type:Individual
Prefix:
First Name:EUNICE
Middle Name:
Last Name:CARTER
Suffix:
Gender:F
Credentials:CHP
Other - Prefix:
Other - First Name:EUNICE
Other - Middle Name:
Other - Last Name:CURTIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CHP
Mailing Address - Street 1:9 HILSIDE ROAD BOX 9
Mailing Address - Street 2:
Mailing Address - City:BUCKLAND
Mailing Address - State:AK
Mailing Address - Zip Code:99727-0009
Mailing Address - Country:US
Mailing Address - Phone:907-494-2122
Mailing Address - Fax:907-494-2104
Practice Address - Street 1:9 HILLSIDE ROAD
Practice Address - Street 2:
Practice Address - City:BUCKLAND
Practice Address - State:AK
Practice Address - Zip Code:99727-0009
Practice Address - Country:US
Practice Address - Phone:907-494-2122
Practice Address - Fax:907-494-2104
Is Sole Proprietor?:No
Enumeration Date:2011-12-12
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK04-651-P172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker