Provider Demographics
NPI:1053731729
Name:CARTER, MELISSA D (NP-C)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:D
Last Name:CARTER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:D
Other - Last Name:MCLEOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5246 GA HIGHWAY 32 E
Mailing Address - Street 2:
Mailing Address - City:NICHOLLS
Mailing Address - State:GA
Mailing Address - Zip Code:31554-5636
Mailing Address - Country:US
Mailing Address - Phone:912-331-0121
Mailing Address - Fax:
Practice Address - Street 1:1101 OCILLA RD
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:GA
Practice Address - Zip Code:31533-2207
Practice Address - Country:US
Practice Address - Phone:912-383-7826
Practice Address - Fax:912-383-7299
Is Sole Proprietor?:No
Enumeration Date:2014-04-22
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN198320363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily