Individual
MS. JUDITH LEE CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
590 COURT STREET, KEENE, NH 03431
(603) 354-5454
(603) 354-6692
Mailing address
590 COURT STREET, DH KEENE FAMILY MEDICINE, KEENE, NH 03431
(802) 365-4354
(802) 365-9435
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
001561
NY
363A00000X
Physician Assistant
Primary
0550030895
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000971
LICENSE NUMBER
CT
01
—
001561
LICENSE NUMBER
NY
01
—
0550030895
LICENSE
VT
05
—
9000369
—
VT
Enumeration date
03/05/2007
Last updated
05/06/2014
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