Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 7439-33 | WI |
N | 363LC1500X | Nurse Practitioner - Community Health | 7439-33 | WI |
NPI | 1912334293 |
---|---|
Provider Name | Miss Megan Carter |
First Address | Dubuque, IA 52001-4016 |
Second Address | Oakdale, MN 55128-7055 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2013 |
Last Update Date | 28/04/2017 |