Individual
KRYSTAL V CARPENTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8416 COUNTY ROAD 279, RIO MEDINA, TX 78066-2521
(210) 965-1611
Mailing address
8416 COUNTY ROAD 279, RIO MEDINA, TX 78066-2521
(210) 965-1611
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
329514
TX
Other
Enumeration date
08/18/2020
Last updated
08/18/2020
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