1356458350 NPI number — MRS. KIRSTIN P CARPENTER PT

Table of content: MRS. KIRSTIN P CARPENTER PT (NPI 1356458350)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356458350 NPI number — MRS. KIRSTIN P CARPENTER PT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARPENTER
Provider First Name:
KIRSTIN
Provider Middle Name:
P
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1356458350
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/18/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1650 LYNDON FARM CT STE 300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40223-5005
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
316-263-0003
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8550 MARSHALL DR
Provider Second Line Business Practice Location Address:
STE 210
Provider Business Practice Location Address City Name:
LENEXA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66214-1505
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-492-0333
Provider Business Practice Location Address Fax Number:
913-492-0334
Provider Enumeration Date:
08/24/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  2003001813 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: 11-03172 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)