Provider Demographics
NPI:1851959399
Name:CARTER, ANITA CHERYL
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:CHERYL
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 1:212 WILLOW VALLEY LAKES DR STE 208
Mailing Address - Street 2:
Mailing Address - City:WILLOW STREET
Mailing Address - State:PA
Mailing Address - Zip Code:17584-9668
Mailing Address - Country:US
Mailing Address - Phone:717-740-4434
Mailing Address - Fax:717-740-4453
Practice Address - Street 1:212 WILLOW VALLEY LAKES DR STE 208
Practice Address - Street 2:
Practice Address - City:WILLOW STREET
Practice Address - State:PA
Practice Address - Zip Code:17584-9668
Practice Address - Country:US
Practice Address - Phone:717-740-4434
Practice Address - Fax:717-740-4453
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-30
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS323986164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse