Provider Demographics
NPI:1891432944
Name:CARTER, LATARSHA MICHELLE
Entity Type:Individual
Prefix:
First Name:LATARSHA
Middle Name:MICHELLE
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 1:6599 E THOMAS RD APT 2099
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6057
Mailing Address - Country:US
Mailing Address - Phone:262-888-9170
Mailing Address - Fax:
Practice Address - Street 1:1764 E GERONIMO ST
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-2200
Practice Address - Country:US
Practice Address - Phone:262-888-9170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant