Provider Demographics
NPI:1972745651
Name:CARTER, ELIZABETH MARY (MSN,RN,CPNP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MARY
Last Name:CARTER
Suffix:
Gender:F
Credentials:MSN,RN,CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1946 9TH AVE STE 405
Mailing Address - Street 2:
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77642-2762
Mailing Address - Country:US
Mailing Address - Phone:409-982-0082
Mailing Address - Fax:409-982-3641
Practice Address - Street 1:1946 9TH AVE STE 405
Practice Address - Street 2:
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77642-2762
Practice Address - Country:US
Practice Address - Phone:409-982-0082
Practice Address - Fax:409-982-3641
Is Sole Proprietor?:No
Enumeration Date:2009-03-27
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX702754363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics