Most Relevant Information
Provider Data
| NPI Number: | 1003295577 |
| Provider Name: | BREANNA CARPENTER |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | PN.147741-M-IV |
Most Important Dates
| Enumeration Date: | 05/29/2015 |
| Last Updated: | 05/29/2015 |
Provider Practice Location
1504 ELM RD NE
WARREN
OH
444834021
Practice Location Phone/Fax
| Phone: | 3304238190 |
| Fax: |
Provider Mailing Location
1504 ELM RD NE
WARREN
OH
444834021
Provider Mailing Phone/Fax
| Phone: | 3304238190 |
| Fax: |