Provider Demographics
NPI:1952669376
Name:CARTHEN, LARIE (FNP)
Entity Type:Individual
Prefix:
First Name:LARIE
Middle Name:
Last Name:CARTHEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 19305
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28219-9305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:807 SCHENCK ST
Practice Address - Street 2:STE 2
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-5122
Practice Address - Country:US
Practice Address - Phone:980-487-2540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-24
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5005685363LF0000X
NC207771363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1952669376Medicaid
SCNP3301Medicaid
NCNC7629EMedicare PIN
NCNC7629FMedicare PIN
NCNC7629CMedicare PIN
NCNC7629DMedicare PIN
NCNC7629BMedicare PIN