Provider Demographics
NPI:1366111676
Name:CARPENTER, LINDSEY NICOLE (PA-C)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:NICOLE
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 N GRANT ST
Mailing Address - Street 2:
Mailing Address - City:CANBY
Mailing Address - State:OR
Mailing Address - Zip Code:97013-3689
Mailing Address - Country:US
Mailing Address - Phone:503-266-2066
Mailing Address - Fax:503-263-8719
Practice Address - Street 1:345 N GRANT ST
Practice Address - Street 2:
Practice Address - City:CANBY
Practice Address - State:OR
Practice Address - Zip Code:97013-3689
Practice Address - Country:US
Practice Address - Phone:503-266-2066
Practice Address - Fax:503-263-8719
Is Sole Proprietor?:No
Enumeration Date:2021-09-09
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant