Healthcare Provider Details

I. General information

NPI: 1780310458
Provider Name (Legal Business Name): JENNIFER CARNER DNP, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2022
Last Update Date: 01/12/2023
Certification Date: 01/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 COMPTON DR
ASHEVILLE NC
28806-2054
US

IV. Provider business mailing address

3760 OWENS MOUNTAIN AVE
CONNELLY SPRINGS NC
28612-7380
US

V. Phone/Fax

Practice location:
  • Phone: 828-254-5356
  • Fax:
Mailing address:
  • Phone: 828-228-3798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number10002446
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5016662
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number287587
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: