Carter, Deshea Donovan

Carter, Deshea Donovan is an individual health care provider with primary practice located at 100 S Bliss Ave , Tahlequah OK 74464-2512. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Carter, Deshea Donovan can be contacted via phone (918) 458-3100.

Contact Information

Primary practice address
100 S Bliss Ave Tahlequah OK 74464-2512
Phone: (918) 458-3100
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 100954 Oklahoma

Profile Details

NPI number 1417071036
LBN Legal business name Carter, Deshea Donovan
Credentials ARPN
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 19th, 2007
Last updated Jan 12th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417071036 NPPES
Tennessee MEDICAID 3905452

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