Provider Demographics
NPI:1972561249
Name:CARPENTER, ANNE MARGARET (RN,MN,CNP,CNS)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:MARGARET
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:RN,MN,CNP,CNS
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:MARGARET
Other - Last Name:KLAUDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN,MN,CNP,CNS
Mailing Address - Street 1:PO BOX 3508
Mailing Address - Street 2:
Mailing Address - City:CORRALES
Mailing Address - State:NM
Mailing Address - Zip Code:87048-3508
Mailing Address - Country:US
Mailing Address - Phone:505-792-0216
Mailing Address - Fax:505-792-0216
Practice Address - Street 1:1400 BARBARA LOOP SE
Practice Address - Street 2:STE. H-4
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-1088
Practice Address - Country:US
Practice Address - Phone:505-892-6562
Practice Address - Fax:505-892-6170
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR45403363LF0000X, 363LG0600X, 364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Not Answered363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Not Answered364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM2077157OtherCIGNA BEHAVIORAL HEALTH
NM2077157OtherCIGNA BEHAVIORAL HEALTH
NMP44874Medicare UPIN