Individual
MARYCOLETTE CARVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1 RIVERSIDE CIR STE 102, ROANOKE, VA 24016-4962
(540) 581-0152
Mailing address
1 RIVERSIDE CIR STE 102, ROANOKE, VA 24016-4962
(540) 581-0152
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001113672
VA
207Q00000X
Family Medicine Physician
Primary
201368
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619011699
—
VA
Enumeration date
02/16/2007
Last updated
09/16/2025
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