Kristine Ross Carpenter, M.D.
Family Medicine in Mattoon, IL. Individual provider (NPI-1).
NPI number1215198189
StatusActive
Last updated in NPPESDec 26, 2014
Details
- NPI
- 1215198189
- Entity type
- Individual (NPI-1)
- Name
- Kristine Ross Carpenter
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 23, 2008
- Last updated
- Dec 26, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 036127366 | IL | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | 149531 | NC |
Other names
- Kristine Marie Ross (Former Name)
Practice location
2512 Hurst Dr.Mattoon, IL 61938
Phone 217-258-5900 · Fax 217-258-3686
Mailing address
611 W. Park St.Bwpc
Urbana, IL 61801-2500
Phone 217-383-6792
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