Healthcare Provider Details

I. General information

NPI: 1093633034
Provider Name (Legal Business Name): AMY ELIZABETH CARPENTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5869 OVERBROOKE RD
DAYTON OH
45440-2333
US

IV. Provider business mailing address

11 EVERGREEN CT
FRANKLIN OH
45005-3071
US

V. Phone/Fax

Practice location:
  • Phone: 937-416-0373
  • Fax:
Mailing address:
  • Phone: 513-850-3946
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number0500554
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: