Provider Demographics
NPI:1427885227
Name:CARPENTIER, CARTER (PA-S)
Entity type:Individual
Prefix:
First Name:CARTER
Middle Name:
Last Name:CARPENTIER
Suffix:
Gender:M
Credentials:PA-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55812-1113
Mailing Address - Country:US
Mailing Address - Phone:800-447-5444
Mailing Address - Fax:
Practice Address - Street 1:940 WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55812-1113
Practice Address - Country:US
Practice Address - Phone:800-447-5444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant