Basic Information
Provider Information
NPI: 1699256883
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CARTER
FirstName: ZHANE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 357 EMERALD SKY CT
Address2:  
City: HENDERSON
State: NV
PostalCode: 890155305
CountryCode: US
TelephoneNumber: 7024721636
FaxNumber:  
Practice Location
Address1: 160 E HORIZON DR STE A
Address2:  
City: HENDERSON
State: NV
PostalCode: 890157934
CountryCode: US
TelephoneNumber: 7026443600
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/24/2018
LastUpdateDate: 08/24/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
372500000X NVN Nursing Service Related ProvidersChore Provider 
372600000X NVN Nursing Service Related ProvidersAdult Companion 
3747A0650X NVN Nursing Service Related ProvidersTechnicianAttendant Care Provider
376J00000X NVN Nursing Service Related ProvidersHomemaker 
3747P1801X NVY Nursing Service Related ProvidersTechnicianPersonal Care Attendant

No ID Information.


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