Provider Demographics
NPI:1316735491
Name:CARPENTER, ANDREA (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:CARPENTER
Suffix:
Gender:
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 KELSEY DR
Mailing Address - Street 2:
Mailing Address - City:ROSSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30741-7236
Mailing Address - Country:US
Mailing Address - Phone:423-605-6971
Mailing Address - Fax:
Practice Address - Street 1:325 KELSEY DR
Practice Address - Street 2:
Practice Address - City:ROSSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30741-7236
Practice Address - Country:US
Practice Address - Phone:423-605-6971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN257719163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health