Provider Demographics
NPI:1316512817
Name:CARTER, SHAWNDA (APRN, PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:SHAWNDA
Middle Name:
Last Name:CARTER
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 DOE RUN DR STE 5
Mailing Address - Street 2:
Mailing Address - City:MT STERLING
Mailing Address - State:KY
Mailing Address - Zip Code:40353-9097
Mailing Address - Country:US
Mailing Address - Phone:859-432-3055
Mailing Address - Fax:859-432-3044
Practice Address - Street 1:601 DOE RUN DR STE 5
Practice Address - Street 2:
Practice Address - City:MT STERLING
Practice Address - State:KY
Practice Address - Zip Code:40353-9097
Practice Address - Country:US
Practice Address - Phone:859-432-3055
Practice Address - Fax:859-432-3044
Is Sole Proprietor?:No
Enumeration Date:2021-05-26
Last Update Date:2022-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3016158363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health