Individual
MRS. TANIYA CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
402 RECOVERY RD, KENNETT, MO 63857-3235
(573) 888-2831
(573) 888-5408
Mailing address
402 RECOVERY RD, KENNETT, MO 63857-3235
(573) 888-2831
(573) 888-5408
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
130959
MO
363LF0000X
Family Nurse Practitioner
Primary
130959
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130959
—
MO
Enumeration date
03/27/2007
Last updated
03/07/2011
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