Individual
JEFF ANDREW CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1124 W 21ST ST, ANDOVER, KS 67002-5500
(316) 300-4000
Mailing address
1124 W 21ST ST, ANDOVER, KS 67002-5500
(806) 220-9802
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
TMP-157280
KS
Other
Enumeration date
10/02/2018
Last updated
10/12/2018
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