Healthcare Provider Details

I. General information

NPI: 1205206190
Provider Name (Legal Business Name): BRITNEY ANN CARLSON CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2015
Last Update Date: 10/27/2022
Certification Date: 10/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 N. HIGLEY
GILBERT AZ
85234
US

IV. Provider business mailing address

4292 E MESQUITE ST
GILBERT AZ
85296-1195
US

V. Phone/Fax

Practice location:
  • Phone: 480-543-2600
  • Fax: 480-981-2407
Mailing address:
  • Phone: 303-681-5738
  • Fax: 480-699-1950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberCRNA1172
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: