Provider Demographics
NPI:1265053706
Name:CARTER, CYNTHIA CHERIE
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:CHERIE
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 1:352 W NORTHFIELD BLVD STE 3C
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-1899
Mailing Address - Country:US
Mailing Address - Phone:844-893-0012
Mailing Address - Fax:
Practice Address - Street 1:950 BRECKENRIDGE LN STE 280
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-5900
Practice Address - Country:US
Practice Address - Phone:844-893-0012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-06
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPA2671363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant