Provider Demographics
NPI:1649690595
Name:CARTER, KARA VANESSA (CRNP)
Entity type:Individual
Prefix:MRS
First Name:KARA
Middle Name:VANESSA
Last Name:CARTER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1359 OLD WATER WORKS RD SW
Mailing Address - Street 2:
Mailing Address - City:FORT PAYNE
Mailing Address - State:AL
Mailing Address - Zip Code:35968-3347
Mailing Address - Country:US
Mailing Address - Phone:256-997-5900
Mailing Address - Fax:
Practice Address - Street 1:1359 OLD WATER WORKS RD SW
Practice Address - Street 2:
Practice Address - City:FORT PAYNE
Practice Address - State:AL
Practice Address - Zip Code:35968-3347
Practice Address - Country:US
Practice Address - Phone:256-997-5900
Practice Address - Fax:888-977-1691
Is Sole Proprietor?:No
Enumeration Date:2014-04-18
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-110129363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health