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ANGELA GAYLE CARTER APRN, BC

Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1083806277

Individual Registrant:
 ANGELA GAYLE CARTER APRN, BC
Gender: F
Not Sole Proprietor

Location and contact information for practice:
797 CLINIC DR  IVYDALE, WV 25113-8263 US
Tel: 304-286-4200  Fax: 304-286-2107

Contact information for business:
PO BOX 147  CLAY, WV 25043-0147 US
Tel: 304-587-2541  Fax: 304-587-2594

Registration Information:
NPI: 1083806277
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
WV57397

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
3810010919WV05




HEALTH CARE JOBS WV - Page 1



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