Provider Demographics
NPI:1053127365
Name:CARTER, HOPE MADISON (PA-C)
Entity type:Individual
Prefix:
First Name:HOPE
Middle Name:MADISON
Last Name:CARTER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 DORCHESTER AVE APT 5
Mailing Address - Street 2:
Mailing Address - City:MIDDLESBORO
Mailing Address - State:KY
Mailing Address - Zip Code:40965-2252
Mailing Address - Country:US
Mailing Address - Phone:606-304-3663
Mailing Address - Fax:
Practice Address - Street 1:915 DORCHESTER AVE APT 5
Practice Address - Street 2:
Practice Address - City:MIDDLESBORO
Practice Address - State:KY
Practice Address - Zip Code:40965-2252
Practice Address - Country:US
Practice Address - Phone:606-304-3663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-10
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical