MEDICARE: BRIAN CARPENTER NP

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	363LF0000X	Family Nurse Practitioner	RN2293612	MA

General Provider Information

NPI Number	:	1760945497
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN CARPENTER NP

Provider Business Mailing Address
First Line	:	71 FERN AVE
Second Line	:
City	:	AMESBURY
State	:	MA
Zip	:	01913-5606
Country	:	US
Telephone Number	:	978-417-9126
Fax Number	:

Provider Business Practice Location Address
First Line	:	290 MERRIMACK ST STE 242
Second Line	:
City	:	LAWRENCE
State	:	MA
Zip	:	01843-1783
Country	:	US
Telephone Number	:	978-837-3333
Fax Number	:

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

Provider Enumeration Date	:	04/10/2019
Last Update Date	:	11/27/2023

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