MEDICARE: KAREN ANNE CARPENTER CMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174H00000X	Health Educator
2	225700000X	Massage Therapist	MT20902272	IN

General Provider Information

NPI Number	:	1568918951
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN ANNE CARPENTER CMT

Provider Business Mailing Address
First Line	:	4130 EAGLE COVE EAST DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46254-4682
Country	:	US
Telephone Number	:	317-525-8388
Fax Number	:	317-377-4706

Provider Business Practice Location Address
First Line	:	6512 E WASHINGTON ST
Second Line	:	INDIANAPOLIS, IN
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-6633
Country	:	US
Telephone Number	:	317-525-8388
Fax Number	:	317-377-4706

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2016
Last Update Date	:	02/28/2023

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