Basic Information
| Provider Information | |||||||||
| NPI: | 1780392852 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CARTER | ||||||||
| FirstName: | ANGELA | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2634 MID SALEM CT | ||||||||
| Address2: | |||||||||
| City: | WINSTON SALEM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 271036977 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3364038601 | ||||||||
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| Practice Location | |||||||||
| Address1: | 609 PROFESSIONAL DR | ||||||||
| Address2: | |||||||||
| City: | ROXBORO | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275734543 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3365999257 | ||||||||
| FaxNumber: | 3365991593 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/08/2022 | ||||||||
| LastUpdateDate: | 11/08/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 236266 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.