Provider Demographics
NPI:1164575528
Name:CARPENTER, KAREN ELIZABETH (DOM)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:ELIZABETH
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:DOM
Other - Prefix:DR
Other - First Name:KAREN
Other - Middle Name:ELIZABETH
Other - Last Name:DOYAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DOM
Mailing Address - Street 1:4312 CARLISLE BLVD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107
Mailing Address - Country:US
Mailing Address - Phone:505-247-1921
Mailing Address - Fax:505-247-1020
Practice Address - Street 1:4312 CARLISLE BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107
Practice Address - Country:US
Practice Address - Phone:505-247-1921
Practice Address - Fax:505-247-1921
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM129171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist