Provider Demographics
NPI:1871994301
Name:KARTER, THERESA MARIE (NP-C)
Entity type:Individual
Prefix:MS
First Name:THERESA
Middle Name:MARIE
Last Name:KARTER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 SAGE DR
Mailing Address - Street 2:
Mailing Address - City:CODY
Mailing Address - State:WY
Mailing Address - Zip Code:82414-8228
Mailing Address - Country:US
Mailing Address - Phone:307-587-2708
Mailing Address - Fax:
Practice Address - Street 1:32 SAGE DR
Practice Address - Street 2:
Practice Address - City:CODY
Practice Address - State:WY
Practice Address - Zip Code:82414-8228
Practice Address - Country:US
Practice Address - Phone:307-587-2708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-16
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY15674.1000207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine