| Doctor Name: | KITRIN LANCE CARPENTER |
| NPI Number: | 1033118849 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PAC |
| License Number: | 1830 |
| Business Practice Address: | 2020 Silver Creek Rd Bldg A Ste 103 Bullhead City, AZ - 864428476 |
| Business Phone Number: | 7028222000 |
| Business Fax Number: | 7029382237 |
| Mailing Address: | 2460 W Horizon Ridge Pkwy, HENDERSON |
| State: | NV |
| Postal Code: | 890522648 |
| Phone Number: | 7028222000 |
| Fax Number: | 7029382237 |
| NPI Enumeration Date: | 07/14/2005 |
| NPI Last Update Date: | 06/24/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 1830 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |