Individual
TIA CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNAP
Contact information
Practice address
101 E WOOD ST, SPARTANBURG, SC 29303-3040
(304) 481-9469
Mailing address
407 FOXHOUND RD, SIMPSONVILLE, SC 29680-6716
(304) 481-9469
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
257038
SC
367500000X
Certified Registered Nurse Anesthetist
Primary
28756
SC
Other
Enumeration date
04/13/2022
Last updated
05/23/2024
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