Provider Demographics
NPI:1760945497
Name:CARPENTER, BRIAN (NP)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:CARPENTER
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 FERN AVE
Mailing Address - Street 2:
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913-5606
Mailing Address - Country:US
Mailing Address - Phone:978-417-9126
Mailing Address - Fax:
Practice Address - Street 1:290 MERRIMACK ST STE 242
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-1783
Practice Address - Country:US
Practice Address - Phone:978-837-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-10
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2293612363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily