Healthcare Provider Details

I. General information

NPI: 1447950829
Provider Name (Legal Business Name): CHRISTINE ROCHELL CARPENTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2023
Last Update Date: 03/06/2023
Certification Date: 03/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 FLEET ST
RANKIN PA
15104-1151
US

IV. Provider business mailing address

220 FLEET ST
RANKIN PA
15104-1151
US

V. Phone/Fax

Practice location:
  • Phone: 412-294-9993
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number66123601
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: