Provider Demographics
NPI:1770451742
Name:CARTER, CIECIA KIXMILLER
Entity type:Individual
Prefix:
First Name:CIECIA
Middle Name:KIXMILLER
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 1:9030 WYNNFIELD DR
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47725-7615
Mailing Address - Country:US
Mailing Address - Phone:678-402-2002
Mailing Address - Fax:678-459-3744
Practice Address - Street 1:9030 WYNNFIELD DR
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47725-7615
Practice Address - Country:US
Practice Address - Phone:678-402-2002
Practice Address - Fax:678-459-3744
Is Sole Proprietor?:No
Enumeration Date:2025-10-29
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05005041A208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation