| Provider / Organization | NPI | Date Certified |
|---|---|---|
| WAYNE CARPENTER | 1053599464 | 2024-07-05 |
Wayne Carpenter is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1053599464. Registration indicates Wayne Carpenter is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner: Family, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner Family, Physician Assistants & Advanced Practice Nursing Providers) (Nurse Practitioner, )
| Entity Type | Individual |
| Provider Name | Mr. Wayne Carpenter FNP |
| Practice Office Address | 36101 BOB HOPE DR SUITE A RANCHO MIRAGE, CA US |
| Practice Office Telephone | 7607734948 |
| Mailing Address | 6351 IMPERIAL DR YUCCA VALLEY, CA 922842252 US |
| Business Telephone | 6192041315 |
| Code | Practice | License No State |
|---|---|---|
| 363LF0000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse PractitionerAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner: Family All Other Specialties & Provider Types Nurse Practitioner Family Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | 95029611
CA |