Provider Demographics
NPI:1235970518
Name:CARTER, GLENDA CHARLENE
Entity type:Individual
Prefix:
First Name:GLENDA
Middle Name:CHARLENE
Last Name:CARTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 MODOC LN
Mailing Address - Street 2:
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-1918
Mailing Address - Country:US
Mailing Address - Phone:202-528-7671
Mailing Address - Fax:
Practice Address - Street 1:3298 FORT LINCOLN DR NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-4341
Practice Address - Country:US
Practice Address - Phone:202-528-7671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-03
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant