Provider Demographics
NPI:1740528926
Name:MCCARTER, AMALIA A (RN)
Entity type:Individual
Prefix:MS
First Name:AMALIA
Middle Name:A
Last Name:MCCARTER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:AMALIA
Other - Middle Name:R
Other - Last Name:ADRIATICO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:3818 AERIAL WAY
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-8750
Mailing Address - Country:US
Mailing Address - Phone:541-607-2743
Mailing Address - Fax:
Practice Address - Street 1:3818 AERIAL WAY
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-8750
Practice Address - Country:US
Practice Address - Phone:541-607-2743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-23
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR098006529RN163W00000X, 163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health