Provider Demographics
NPI:1821609777
Name:CARPENTER, KATRICE (RNC-OB)
Entity Type:Individual
Prefix:
First Name:KATRICE
Middle Name:
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:RNC-OB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 194
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29602-0194
Mailing Address - Country:US
Mailing Address - Phone:864-386-2808
Mailing Address - Fax:
Practice Address - Street 1:104 SAXON FALLS CT
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-5374
Practice Address - Country:US
Practice Address - Phone:864-386-2808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-13
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC99907163WX0003X, 163W00000X
172V00000X, 174H00000X, 374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient
No172V00000XOther Service ProvidersCommunity Health Worker
No174H00000XOther Service ProvidersHealth Educator
No374J00000XNursing Service Related ProvidersDoula