Provider Demographics
NPI:1023521721
Name:CARTER, JENNIFER (WHNP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:CARTER
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8115
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75404-8115
Mailing Address - Country:US
Mailing Address - Phone:903-454-2130
Mailing Address - Fax:903-454-5487
Practice Address - Street 1:4221 RIDGECREST
Practice Address - Street 2:SUITE 103
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75402
Practice Address - Country:US
Practice Address - Phone:903-454-2130
Practice Address - Fax:903-454-5487
Is Sole Proprietor?:No
Enumeration Date:2017-11-16
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX562365363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology