Individual
MS. DESHEA DONOVAN CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARPN
Contact information
Practice address
100 S BLISS AVE, TAHLEQUAH, OK 74464-2512
(918) 458-3100
Mailing address
605 W 3RD ST, TAHLEQUAH, OK 74464-4624
(918) 822-7758
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
100954
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3905452
—
TN
Enumeration date
03/19/2007
Last updated
01/12/2012
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