Individual
ELIJAH CARTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
1002 GLENVIEW DR, GLASGOW, KY 42141-3424
(731) 394-1145
(615) 328-3758
Mailing address
PO BOX 269084, DEPT 1102, OKLAHOMA CITY, OK 73126
(731) 394-1145
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
210485
TN
363LF0000X
Family Nurse Practitioner
29691
TN
363LF0000X
Family Nurse Practitioner
Primary
3018998
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29691
STATE LICENSURE
TN
Enumeration date
05/09/2020
Last updated
01/09/2025
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