Provider Demographics
NPI:1154173045
Name:GAITER, CARMEN LOUISE
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:LOUISE
Last Name:GAITER
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 1:445 S MAPLE ST UNIT 116
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44302-1447
Mailing Address - Country:US
Mailing Address - Phone:330-258-3949
Mailing Address - Fax:
Practice Address - Street 1:445 S MAPLE ST UNIT 116
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44302-1447
Practice Address - Country:US
Practice Address - Phone:330-258-3949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care