1356021893 NPI number — DR. LEXI LISA CARTER DNP, APRN, FNP-C

Table of content: DR. LEXI LISA CARTER DNP, APRN, FNP-C (NPI 1356021893)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356021893 NPI number — DR. LEXI LISA CARTER DNP, APRN, FNP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARTER
Provider First Name:
LEXI
Provider Middle Name:
LISA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DNP, APRN, FNP-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SIMPSON
Provider Other First Name:
LEXI
Provider Other Middle Name:
LISA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1356021893
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/19/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
27 MARLBORO AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AUGUSTA
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04330-6626
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4 GLEN COVE DR STE 202
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCKPORT
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04856-4238
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-301-3730
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/19/2023

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  CNP231270 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 121695100 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".