Provider Demographics
NPI:1558061291
Name:CARPENTER, JAYNE L (IBCLC, CBS, OBC)
Entity Type:Individual
Prefix:
First Name:JAYNE
Middle Name:L
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:IBCLC, CBS, OBC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 WHITE OAK HL
Mailing Address - Street 2:
Mailing Address - City:WEAVERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28787-9502
Mailing Address - Country:US
Mailing Address - Phone:828-202-9379
Mailing Address - Fax:
Practice Address - Street 1:17 WHITE OAK HL
Practice Address - Street 2:
Practice Address - City:WEAVERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28787-9502
Practice Address - Country:US
Practice Address - Phone:828-202-9379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-09
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN