Provider Demographics
NPI:1861264897
Name:CARTER, KATHRYN (FNP-BC)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:CARTER
Suffix:
Gender:F
Credentials:FNP-BC
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 517
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:NC
Mailing Address - Zip Code:28337-0517
Mailing Address - Country:US
Mailing Address - Phone:910-862-5500
Mailing Address - Fax:910-862-5501
Practice Address - Street 1:300A E MCKAY ST
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:NC
Practice Address - Zip Code:28337-9037
Practice Address - Country:US
Practice Address - Phone:910-862-5500
Practice Address - Fax:910-862-5501
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5019051363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner