Provider Demographics
NPI:1881252369
Name:CARPENTER, CRISTEN SHERE' (MSN-L, MBA, FNP-C)
Entity type:Individual
Prefix:MISS
First Name:CRISTEN
Middle Name:SHERE'
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:MSN-L, MBA, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1840 E BROADWAY RD
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-1614
Mailing Address - Country:US
Mailing Address - Phone:480-927-1005
Mailing Address - Fax:480-927-1090
Practice Address - Street 1:1840 E BROADWAY RD
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-1614
Practice Address - Country:US
Practice Address - Phone:480-927-1005
Practice Address - Fax:480-927-1090
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-30
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ235698363LF0000X
AZRN159988163WC1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development