Healthcare Provider Details

I. General information

NPI: 1396962478
Provider Name (Legal Business Name): LYNN M CARPENTER AUD, FAAA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 01/24/2020
Certification Date: 01/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7901 SCHATZ POINTE DR
DAYTON OH
45459-3824
US

IV. Provider business mailing address

7901 SCHATZ POINTE DR STE E
DAYTON OH
45459-3824
US

V. Phone/Fax

Practice location:
  • Phone: 937-435-5033
  • Fax: 937-435-5512
Mailing address:
  • Phone: 937-435-5033
  • Fax: 937-435-5512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberA 01009
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberA 01009
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: