Provider Demographics
NPI:1790373777
Name:CARPENTER, SAMANTHA JOAN (CPNP-PC, AC)
Entity type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:JOAN
Last Name:CARPENTER
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Gender:F
Credentials:CPNP-PC, AC
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Mailing Address - Street 1:1 CHILDRENS PLZ
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45404-1815
Mailing Address - Country:US
Mailing Address - Phone:937-641-3000
Mailing Address - Fax:
Practice Address - Street 1:1 CHILDRENS PLZ
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45404-1815
Practice Address - Country:US
Practice Address - Phone:937-641-3477
Practice Address - Fax:937-641-5410
Is Sole Proprietor?:No
Enumeration Date:2021-01-06
Last Update Date:2022-04-07
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Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0027627363LP2300X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care