Provider Demographics
NPI:1427882935
Name:CARPENTER, LEAH RUTH (RDN, MS)
Entity type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:RUTH
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:RDN, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2734 MEADOW PL
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35475-4814
Mailing Address - Country:US
Mailing Address - Phone:205-861-5191
Mailing Address - Fax:
Practice Address - Street 1:2734 MEADOW PL
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35475-4814
Practice Address - Country:US
Practice Address - Phone:205-861-5191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL86154386133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty