Individual
MS. REBECCA LYN CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
4550 MEMORIAL DR STE 280, BELLEVILLE, IL 62226-5372
(618) 767-3235
(618) 624-4982
Mailing address
PO BOX 959203, SAINT LOUIS, MO 63195-9203
(618) 767-3235
(618) 624-4982
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209020059
IL
363LA2200X
Adult Health Nurse Practitioner
2014041453
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420019194
—
MO
Enumeration date
01/05/2015
Last updated
02/16/2026
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