Individual
JAMIE L CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
7145 GOODMAN RD, OLIVE BRANCH, MS 38654-1904
(662) 333-5001
(662) 420-7063
Mailing address
7145 GOODMAN RD, OLIVE BRANCH, MS 38654-1904
(662) 333-5001
(662) 420-7063
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
163971
TN
363L00000X
Nurse Practitioner
Primary
902936
MS
363LF0000X
Family Nurse Practitioner
19660
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02374577
—
MS
Enumeration date
02/13/2015
Last updated
12/17/2018
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