MEDICARE: CLAUDIA J CARLSON FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	9371898	FL

General Provider Information

NPI Number	:	1730156290
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAUDIA J CARLSON FNP

Provider Business Mailing Address
First Line	:	622 DUNDEE LN
Second Line	:
City	:	HOLMES BEACH
State	:	FL
Zip	:	34217-1216
Country	:	US
Telephone Number	:	503-819-3132
Fax Number	:

Provider Business Practice Location Address
First Line	:	622 DUNDEE LN
Second Line	:
City	:	HOLMES BEACH
State	:	FL
Zip	:	34217-1216
Country	:	US
Telephone Number	:	503-819-3132
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2006
Last Update Date	:	02/11/2016

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