Provider Demographics
NPI:1851548846
Name:CARTER, SUE A (NP)
Entity type:Individual
Prefix:
First Name:SUE
Middle Name:A
Last Name:CARTER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:30 W MCCREIGHT AVE
Mailing Address - Street 2:STE 208
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45504-1853
Mailing Address - Country:US
Mailing Address - Phone:937-328-7266
Mailing Address - Fax:937-328-5276
Practice Address - Street 1:46 FAIRVIEW AVE STE 111
Practice Address - Street 2:
Practice Address - City:SKOWHEGAN
Practice Address - State:ME
Practice Address - Zip Code:04976-1481
Practice Address - Country:US
Practice Address - Phone:207-474-0905
Practice Address - Fax:207-474-6930
Is Sole Proprietor?:No
Enumeration Date:2008-08-21
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.10165363LF0000X
MECNP221014363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2922145Medicaid
ME1851548846Medicaid
OHNP37401Medicare PIN