Individual
MS. JAMIE L CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
3100 CHANNING WAY, IDAHO FALLS, ID 83404-7533
(208) 529-6111
Mailing address
3100 CHANNING WAY, IDAHO FALLS, ID 83404-7533
(208) 529-6111
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-528
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807062200
—
ID
Enumeration date
06/17/2005
Last updated
08/14/2013
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