Provider Demographics
NPI:1689492886
Name:CARTER, KHARON LAMONT
Entity type:Individual
Prefix:
First Name:KHARON
Middle Name:LAMONT
Last Name:CARTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2532 HARRISON AVE APT 7
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45211-7858
Mailing Address - Country:US
Mailing Address - Phone:513-999-3084
Mailing Address - Fax:
Practice Address - Street 1:2532 HARRISON AVE APT 7
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-7858
Practice Address - Country:US
Practice Address - Phone:513-999-3084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-27
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide