Basic Information
Provider Information
NPI: 1932501764
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CARTER
FirstName: KIMBERLY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2000 NEUSE BLVD
Address2:  
City: NEW BERN
State: NC
PostalCode: 285603449
CountryCode: US
TelephoneNumber: 2526338640
FaxNumber: 2526365376
Practice Location
Address1: 2000 NEUSE BLVD
Address2:  
City: NEW BERN
State: NC
PostalCode: 285603449
CountryCode: US
TelephoneNumber: 2526338640
FaxNumber: 2526365376
Other Information
ProviderEnumerationDate: 09/24/2014
LastUpdateDate: 09/24/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X98225NCY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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