Provider Demographics
NPI:1821306002
Name:CARPENTER, KRISTI LYNN (CNP)
Entity Type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:LYNN
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 TOWER BLVD # B
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44052-5235
Mailing Address - Country:US
Mailing Address - Phone:440-989-4874
Mailing Address - Fax:
Practice Address - Street 1:1130 TOWER BLVD # B
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44052-5235
Practice Address - Country:US
Practice Address - Phone:440-989-4874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-21
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA0710018363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health