Healthcare Provider Details

I. General information

NPI: 1851088181
Provider Name (Legal Business Name): KELLY ANN CARLSON DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2023
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 VALLEY BROOK RD STE 300
MC MURRAY PA
15317-3367
US

IV. Provider business mailing address

2 ALLEGHENY CTR STE 530
PITTSBURGH PA
15212-5404
US

V. Phone/Fax

Practice location:
  • Phone: 724-941-5588
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS025956
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: