Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | RN214915 | GA |
NPI | 1013485382 |
---|---|
Provider Name | Alisha Dalila Carter |
First Address | Warner Robins, GA 31088-9424 |
Second Address | Warner Robins, GA 31088-8995 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2018 |
Last Update Date | 10/06/2021 |