Provider Demographics
NPI:1699584417
Name:CARTER, DARIEN NYCOLE
Entity type:Individual
Prefix:
First Name:DARIEN
Middle Name:NYCOLE
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 1:1777 RUBE SMITH RD
Mailing Address - Street 2:
Mailing Address - City:CANMER
Mailing Address - State:KY
Mailing Address - Zip Code:42722-9499
Mailing Address - Country:US
Mailing Address - Phone:270-584-4330
Mailing Address - Fax:
Practice Address - Street 1:718 GOODWIN LN
Practice Address - Street 2:
Practice Address - City:LEITCHFIELD
Practice Address - State:KY
Practice Address - Zip Code:42754-1400
Practice Address - Country:US
Practice Address - Phone:270-259-4036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4033737363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care