Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | 95007500 | CA |
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 95007500 | CA |
NPI | 1629584099 |
---|---|
Provider Name | Brooke Carpenter |
First Address | San Francisco, CA 94115-1843 |
Second Address | San Francisco, CA 94115-1925 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2017 |
Last Update Date | 21/12/2017 |