Individual
CHARLES KEITH CARPENTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
4000 WELLNESS DR, MIDLAND, MI 48670-2483
(844) 832-1956
Mailing address
PO BOX 3272, SAGINAW, MI 48605-3272
(989) 797-1400
(989) 797-4077
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704271364
MI
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
4704271364
MI
163WC3500X
Cardiac Rehabilitation Registered Nurse
4704271364
MI
363LF0000X
Family Nurse Practitioner
Primary
4704271364
MI
Other
Enumeration date
01/06/2010
Last updated
02/14/2023
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