Individual
MEGAN GREEN CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
551 MEDICAL DR, CLARKSDALE, MS 38614-6733
(662) 624-2531
Mailing address
216 PORTER DR, CLARKSDALE, MS 38614-9389
(662) 418-9484
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
903083
MS
Other
Enumeration date
01/02/2019
Last updated
07/02/2020
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