Provider Demographics
NPI:1285959692
Name:CARTER, RACHAEL LEIGH (NP-C)
Entity type:Individual
Prefix:MRS
First Name:RACHAEL
Middle Name:LEIGH
Last Name:CARTER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:289 HOG HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:TN
Mailing Address - Zip Code:37615-2103
Mailing Address - Country:US
Mailing Address - Phone:423-384-8645
Mailing Address - Fax:423-224-5506
Practice Address - Street 1:130 W RAVINE RD
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-3837
Practice Address - Country:US
Practice Address - Phone:423-224-5500
Practice Address - Fax:423-224-5506
Is Sole Proprietor?:No
Enumeration Date:2010-03-30
Last Update Date:2010-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024168731363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily