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Individual

JODIE CARPENTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
199 S. MCCLEARY RD, EXCELSIOR SPRINGS, MO 64024
(816) 630-6071
(816) 630-4465
Mailing address
PO BOX 219672, KANSAS CITY, MO 64121-9672
(816) 360-6071
(816) 630-4465

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2015018032
MO

Other

Enumeration date
06/25/2015
Last updated
12/09/2016
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