Provider Demographics
NPI:1891492690
Name:CARTER, JASMINE L
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:L
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 1:4631 W NICKLAS AVE APT D
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73132-6926
Mailing Address - Country:US
Mailing Address - Phone:405-314-9447
Mailing Address - Fax:
Practice Address - Street 1:4631 W NICKLAS AVE APT D
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73132-6926
Practice Address - Country:US
Practice Address - Phone:405-314-9447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist