Individual
ANDREA CARPENTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
3275 HIGHWAY 371 N, MANTACHIE, MS 38855-7145
(662) 282-7555
(662) 346-7074
Mailing address
3275 HIGHWAY 371 N, MANTACHIE, MS 38855-7145
(662) 282-7555
(662) 346-7074
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
902761
MS
Other
Enumeration date
09/27/2018
Last updated
07/22/2019
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