Provider Demographics
NPI:1285458018
Name:CARTER, AMY ABADE
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:ABADE
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 1:1115 SILVER LN
Mailing Address - Street 2:
Mailing Address - City:CARTER LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:51510-1217
Mailing Address - Country:US
Mailing Address - Phone:402-714-3029
Mailing Address - Fax:
Practice Address - Street 1:1115 SILVER LN
Practice Address - Street 2:
Practice Address - City:CARTER LAKE
Practice Address - State:IA
Practice Address - Zip Code:51510-1217
Practice Address - Country:US
Practice Address - Phone:402-714-3029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-08
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA155537163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice