Provider Demographics
NPI:1366734865
Name:CARTER, LYNN (RPH)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:CARTER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2065 EXPERIMENT STATION RD
Mailing Address - Street 2:
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-5321
Mailing Address - Country:US
Mailing Address - Phone:706-769-5654
Mailing Address - Fax:706-769-2876
Practice Address - Street 1:2065 EXPERIMENT STATION RD
Practice Address - Street 2:
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-5321
Practice Address - Country:US
Practice Address - Phone:706-769-5654
Practice Address - Fax:706-769-2876
Is Sole Proprietor?:No
Enumeration Date:2011-05-03
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA014788183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist