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General NPI Number Information
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NPI Number | 1720946643
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Entity Type | Individual
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Provider Name | AZALEAH CARPENTER RN
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Gender | Female
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Dates
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Enumeration Date | 01/10/2026
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Last Update Date | 01/10/2026
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Provider Practice Location Address
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Address Line | 1429 PENNSYLVANIA AVE
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City | HARTSHORNE
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State | OK
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Zip | 74547-3839
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Country | US
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Telephone | 918-426-2442
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 119
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City | RED OAK
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State | OK
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Zip | 74563-0119
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Country | US
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Telephone | 918-448-1690
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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 | 223539
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License Number State | OK
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