Provider Demographics
NPI:1568294189
Name:CARPENTER, SARAH MICHELLE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:MICHELLE
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:MICHELLE
Other - Last Name:MANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16143 DARTOLO RD
Mailing Address - Street 2:
Mailing Address - City:RAMONA
Mailing Address - State:CA
Mailing Address - Zip Code:92065-4667
Mailing Address - Country:US
Mailing Address - Phone:619-540-6605
Mailing Address - Fax:
Practice Address - Street 1:16143 DARTOLO RD
Practice Address - Street 2:
Practice Address - City:RAMONA
Practice Address - State:CA
Practice Address - Zip Code:92065-4667
Practice Address - Country:US
Practice Address - Phone:619-540-6605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-14
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95032074363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily