Individual
OLIVIA UVON CARTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3522 W LISBON AVE, MILWAUKEE, WI 53208-1953
(414) 935-8000
Mailing address
PO BOX 772654, DETROIT, MI 48277-0001
(414) 935-8000
(414) 344-3319
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
7060-23
WI
363AM0700X
Medical Physician Assistant
Primary
7060-23
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/02/2022
Last updated
08/25/2022
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