Provider Demographics
NPI:1811461908
Name:CARPENTER, KENZIE (AGACNP,RNFA)
Entity type:Individual
Prefix:
First Name:KENZIE
Middle Name:
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:AGACNP,RNFA
Other - Prefix:
Other - First Name:KENZIE
Other - Middle Name:
Other - Last Name:DYE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AGACNP,RNFA
Mailing Address - Street 1:2400 PATTERSON ST STE 400
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1575
Mailing Address - Country:US
Mailing Address - Phone:615-342-7440
Mailing Address - Fax:
Practice Address - Street 1:2400 PATTERSON ST STE 400
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1575
Practice Address - Country:US
Practice Address - Phone:615-342-7440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-11
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN55163WR0006X
TN25241363LA2100X, 363LG0600X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology