Provider Demographics
NPI:1801157375
Name:CARTER, MILLICENT WILLETTE
Entity type:Individual
Prefix:MRS
First Name:MILLICENT
Middle Name:WILLETTE
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 1:2912 SOUTHERN AVE SE
Mailing Address - Street 2:APT. #4
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-1732
Mailing Address - Country:US
Mailing Address - Phone:202-367-7533
Mailing Address - Fax:
Practice Address - Street 1:2912 SOUTHERN AVE SE
Practice Address - Street 2:APT. #4
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-1732
Practice Address - Country:US
Practice Address - Phone:202-367-7533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-31
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide