Provider Demographics
NPI:1629931969
Name:CARTER, MAYCEE
Entity type:Individual
Prefix:
First Name:MAYCEE
Middle Name:
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 1:54 ALAMO LN
Mailing Address - Street 2:
Mailing Address - City:BOMONT
Mailing Address - State:WV
Mailing Address - Zip Code:25030-9655
Mailing Address - Country:US
Mailing Address - Phone:304-514-0789
Mailing Address - Fax:
Practice Address - Street 1:54 ALAMO LN
Practice Address - Street 2:
Practice Address - City:BOMONT
Practice Address - State:WV
Practice Address - Zip Code:25030-9655
Practice Address - Country:US
Practice Address - Phone:304-514-0789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-12-04
Last Update Date:2025-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide