| NPI | 1538822713 |
|---|---|
| Former Name | CHARVETTA TERRIA SHANAE CARTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH LPN.163915.MEDS-IV) |
| Enumeration Date | 2021-10-14 |
| Last Update Date | 2022-09-07 |