Provider Demographics
NPI:1447006671
Name:CARPENTER, BRANDI (LVN)
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1851 BRINKER RD APT 1108
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76208-1261
Mailing Address - Country:US
Mailing Address - Phone:945-536-4142
Mailing Address - Fax:
Practice Address - Street 1:4400 STATE HIGHWAY 121 STE 700
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75056-4952
Practice Address - Country:US
Practice Address - Phone:945-536-4142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA723277164X00000X
TX1056848164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse