Provider Demographics
NPI:1083479117
Name:CARTER, SHAMEKA DENISE (FNP)
Entity type:Individual
Prefix:
First Name:SHAMEKA
Middle Name:DENISE
Last Name:CARTER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 ELECTRIC DR
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29153-1933
Mailing Address - Country:US
Mailing Address - Phone:803-905-5100
Mailing Address - Fax:803-905-5170
Practice Address - Street 1:755 ELECTRIC DR
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29153-1933
Practice Address - Country:US
Practice Address - Phone:803-905-5100
Practice Address - Fax:803-905-5170
Is Sole Proprietor?:No
Enumeration Date:2024-02-19
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC29512363LF0000X, 207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily