Provider Demographics
NPI:1902953086
Name:CARPENTER, JOAN GLEBA (MN, RN, NP-C)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:GLEBA
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:MN, RN, NP-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:12106 LANDINGS BLVD
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:MD
Mailing Address - Zip Code:21811
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6085 MARSHALEE DR
Practice Address - Street 2:SUITE 110
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6023
Practice Address - Country:US
Practice Address - Phone:302-559-5627
Practice Address - Fax:410-379-3591
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DELG-0000344363LF0000X
MDAC000236363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily