Provider Demographics
NPI:1356819965
Name:CARPENTER, ADRIA EYVETTE
Entity Type:Individual
Prefix:
First Name:ADRIA
Middle Name:EYVETTE
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 1:405 STRONG RD APT 144
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:FL
Mailing Address - Zip Code:32351-5001
Mailing Address - Country:US
Mailing Address - Phone:850-510-8773
Mailing Address - Fax:
Practice Address - Street 1:405 STRONG RD APT 144
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:FL
Practice Address - Zip Code:32351-5001
Practice Address - Country:US
Practice Address - Phone:850-510-8773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-13
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty