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Individual

SHARON JEAN CARPENTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1530 NEEDMORE RD, STE 300, DAYTON, OH 45414
(937) 277-4274
(937) 277-8476
Mailing address
1530 NEEDMORE RD, STE 300, DAYTON, OH 45414
(937) 277-4274
(937) 277-8476

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
50000376
OH
363AM0700X
Medical Physician Assistant
Primary
50.000376RX
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0067771
OH
Enumeration date
10/27/2006
Last updated
01/28/2021
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