Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | 201706386NP-PP | OR |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 201704010NP-PP | OR |
NPI | 1033658539 |
---|---|
Provider Name | Brandy Masters Carpenter |
First Address | Hillsboro, OR 97123 |
Second Address | Portland, OR 97210-2974 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2017 |
Last Update Date | 17/09/2018 |