Provider Demographics
NPI:1336258953
Name:CARTER, CATHERINE DILTS (RN MS CPNP)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:DILTS
Last Name:CARTER
Suffix:
Gender:F
Credentials:RN MS CPNP
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Other - First Name:
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Mailing Address - Street 1:5024 N ROYAL DR.
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-9230
Mailing Address - Country:US
Mailing Address - Phone:231-935-0555
Mailing Address - Fax:231-935-0562
Practice Address - Street 1:5024 N ROYAL DR.
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-9230
Practice Address - Country:US
Practice Address - Phone:231-935-0555
Practice Address - Fax:231-935-0562
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704146509363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner