Individual
TIMOTHY JAMES CARPENTER II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2485 HEMBY LN, SUITE A, GREENVILLE, NC 27834-3701
(252) 752-2140
(888) 787-2249
Mailing address
2485 HEMBY LN, SUITE A, GREENVILLE, NC 27834-3701
(252) 752-2140
(888) 787-2249
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
163278
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
89986
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1801162417
TRICARE
NC
05
—
8054193
—
NC
01
—
P1111572
RAILROAD MEDICARE
NC
Enumeration date
03/28/2012
Last updated
08/27/2014
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