Provider Demographics
NPI:1780392852
Name:CARTER, ANGELA MARIE (FNP-BC)
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:MARIE
Last Name:CARTER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2634 MID SALEM CT
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-6977
Mailing Address - Country:US
Mailing Address - Phone:336-403-8601
Mailing Address - Fax:
Practice Address - Street 1:609 PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:ROXBORO
Practice Address - State:NC
Practice Address - Zip Code:27573-4543
Practice Address - Country:US
Practice Address - Phone:336-599-9257
Practice Address - Fax:336-599-1593
Is Sole Proprietor?:No
Enumeration Date:2022-11-08
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5017208363LF0000X
NC236266163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse