Individual
BRENDA C CARPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1000 JOHNSON FERRY RD NE, ATLANTA, GA 30342-1606
(404) 851-8000
Mailing address
PO BOX 2968, KENNESAW, GA 30156-9117
(770) 779-0015
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
RN038702
GA
363AM0700X
Medical Physician Assistant
RN038702
GA
363L00000X
Nurse Practitioner
Primary
RN038702
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000927022
—
GA
05
—
000927022A
—
GA
01
—
10043467
AMERIGROUP
GA
01
—
333443
WELLCARE
GA
Enumeration date
05/16/2006
Last updated
10/06/2010
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