Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 11011922 | FL |
NPI | 1033795232 |
---|---|
Provider Name | Stacy Carter |
First Address | Davie, FL 33328-6951 |
Second Address | Davie, FL 33328-6951 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2021 |
Last Update Date | 19/03/2021 |