Individual
MRS. KARA DARLENE CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
303 OHIO AVE, CHARLESTON, WV 25302-2212
(681) 205-8701
(681) 208-8702
Mailing address
104 ALEX LN, CHARLESTON, WV 25304-2952
(304) 734-2040
(304) 734-2047
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
01058
WV
363AM0700X
Medical Physician Assistant
Primary
01058
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001720818
BLUE CROSS BLUE SHIELD
WV
05
—
0107132
—
OH
01
—
1069109
WV DWC
WV
05
—
1245228501
—
WV
05
—
7100274210
—
KY
Enumeration date
10/11/2005
Last updated
10/15/2024
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