Individual
MS. CINDY LOU CARPENTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A/L.P.N
Contact information
Practice address
711 WATERLOO GENEVA RD, WATERLOO, NY 13165-1206
(315) 909-4868
Mailing address
711 WATERLOO GENEVA RD, WATERLOO, NY 13165-1206
(315) 909-4868
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
010081981
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
895822287
DRIVER ID
NY
Enumeration date
03/15/2021
Last updated
03/15/2021
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