Healthcare Provider Details

I. General information

NPI: 1417051913
Provider Name (Legal Business Name): DEBORAH ZAHN CARLSON C.N.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 09/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 LIBBEY PKWY SUITE 105
EAST WEYMOUTH MA
02189-3129
US

IV. Provider business mailing address

90 LIBBEY PARKWAY SUITE 105
S WEYMOUTH MA
02189
US

V. Phone/Fax

Practice location:
  • Phone: 339-201-4120
  • Fax: 781-545-8117
Mailing address:
  • Phone: 339-201-4120
  • Fax: 781-545-8117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number207861
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: