Charlotte Carter, RN

Individual provider Active NPI School Registered Nurse · San Jon, NM

NPI 1831702901 · NPPES record last updated Aug 28, 2020

Key facts

NPI
1831702901
Entity type
Individual (NPI type 1)
Primary specialty
School Registered Nurse 163WS0200X
License
55479 (NM)
Practice address
7TH and Elm St
San Jon, NM 88434
Phone
(575) 576-2466
Fax
(575) 576-2772
NPI assigned
Aug 28, 2020
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
55479NMMDSchool Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
San Jon School Based Health Center Past
since Aug 30, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 55479 NM Yes

Addresses

Primary practice location

7TH and Elm St
San Jon, NM 88434

Mailing address

PO Box 303
Logan, NM 88426-0303
Phone (806) 679-1195

Other providers in San Jon, NM

All providers in San Jon, NM · School Registered Nurse in New Mexico

Sources for this page

Verify at the official NPI Registry.