Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | AP30005099 | WA |
NPI | 1225121890 |
---|---|
Provider Name | Dr. Becky Sue Carter |
First Address | Renton, WA 98055-5714 |
Second Address | Renton, WA 98055-5714 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 29/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9629957 | (05) | WA |
P16220 | (02) | WA |