Provider Demographics
NPI:1720782444
Name:CARTER, DANA MARIE (FNP-C)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:MARIE
Last Name:CARTER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 959354
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63195-4471
Mailing Address - Country:US
Mailing Address - Phone:314-953-6801
Mailing Address - Fax:314-953-6819
Practice Address - Street 1:1225 GRAHAM RD STE 230C
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-8012
Practice Address - Country:US
Practice Address - Phone:314-953-6801
Practice Address - Fax:314-953-6819
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-28
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOF03230538363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily