Individual
DESIREE MICHELLETTE CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
779 MONUMENT AVE, WOODBRIDGE, VA 22191-5406
(757) 775-2455
Mailing address
779 MONUMENT AVE, WOODBRIDGE, VA 22191-5406
(757) 775-2455
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0002090993
VA
Other
Enumeration date
09/19/2018
Last updated
09/19/2018
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