Provider Demographics
NPI:1164808135
Name:CARPENTER, APRIL MELISSA
Entity Type:Individual
Prefix:MRS
First Name:APRIL
Middle Name:MELISSA
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 NEELY LN
Mailing Address - Street 2:
Mailing Address - City:CANYON
Mailing Address - State:TX
Mailing Address - Zip Code:79015-6470
Mailing Address - Country:US
Mailing Address - Phone:806-216-0738
Mailing Address - Fax:
Practice Address - Street 1:22 NEELY LN
Practice Address - Street 2:
Practice Address - City:CANYON
Practice Address - State:TX
Practice Address - Zip Code:79015-6470
Practice Address - Country:US
Practice Address - Phone:806-216-0738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-31
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX213369224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX40189OtherSAMARITAN MINISTRIES