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General NPI Number Information
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NPI Number | 1588389340
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Entity Type | Individual
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Provider Name | MICHELLE LEE CARPENTER RN
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Gender | Female
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Dates
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Enumeration Date | 10/04/2022
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Last Update Date | 10/04/2022
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Provider Practice Location Address
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Address Line | 30 ALANIA PL APT A
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City | KIHEI
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State | HI
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Zip | 96753-7373
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Country | US
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Telephone | 701-320-1911
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Fax |
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Provider Business Mailing Address
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Address Line | 30 ALANIA PL APT A
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City | KIHEI
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State | HI
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Zip | 96753-7373
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Country | US
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Telephone | 701-320-1911
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 95031621
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | R33425
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License Number State | ND
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Taxonomy #3
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | RN-96869
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License Number State | HI
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