Healthcare Provider Details

I. General information

NPI: 1245983634
Provider Name (Legal Business Name): RACHEL L CARLSON RN-SRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2022
Last Update Date: 01/27/2022
Certification Date: 01/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY OF PITTSBURGH SCHOOL OF NURSING NURSE ANESTH VB 360A, 3500 VICTORIA STREET
PITTSBURGH PA
15261
US

IV. Provider business mailing address

4110 EDGE RD
PITTSBURGH PA
15227
US

V. Phone/Fax

Practice location:
  • Phone: 888-747-0794
  • Fax:
Mailing address:
  • Phone: 570-439-4777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN720116
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: