Individual
MS. KIMBERLY M CARPENTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
720 N PINE ST, SPARTANBURG, SC 29303-3127
(864) 560-5800
(864) 592-0586
Mailing address
PO BOX 4718, SPARTANBURG, SC 29305-4718
(864) 592-0586
(864) 592-0586
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
70300
SC
367500000X
Certified Registered Nurse Anesthetist
Primary
1325
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AN0913
—
SC
Enumeration date
04/13/2006
Last updated
09/08/2023
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