Provider Demographics
NPI:1720194236
Name:CARPENTER, JULIE LANKFORD (APN)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:LANKFORD
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:A
Other - Last Name:LANKFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:11851 DETROIT AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-3016
Mailing Address - Country:US
Mailing Address - Phone:216-529-7125
Mailing Address - Fax:
Practice Address - Street 1:209 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:HIGHLANDS
Practice Address - State:NC
Practice Address - Zip Code:28741-7623
Practice Address - Country:US
Practice Address - Phone:828-482-6160
Practice Address - Fax:828-482-5380
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5018950363LF0000X
OH37851363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1517538Medicaid
TN1517538Medicaid
TN36441082Medicare PIN