Provider Demographics
NPI:1316999774
Name:CARPENTER, BARBARA BOURKE (ARNP)
Entity type:Individual
Prefix:MISS
First Name:BARBARA
Middle Name:BOURKE
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E LIBERTY ST STE 800
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1428
Mailing Address - Country:US
Mailing Address - Phone:502-895-8970
Mailing Address - Fax:502-895-8971
Practice Address - Street 1:200 ABRAHAM FLEXNER WAY
Practice Address - Street 2:HMA DEPT
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1861
Practice Address - Country:US
Practice Address - Phone:502-569-7983
Practice Address - Fax:502-589-4989
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2740P363L00000X
KY3002740363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000360855OtherANTHEM PROVIDER NO.
KY50006767OtherPASPORT PROVIDER NO.
IN200507470Medicaid
KY78013638Medicaid
IN630960IMedicare PIN
IN129980JMedicare PIN
KY000000360855OtherANTHEM PROVIDER NO.
KYQ32627Medicare UPIN