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General NPI Number Information
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NPI Number | 1093203861
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Entity Type | Individual
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Provider Name | CARRIE PEDERSEN FNP
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Gender | Female
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Dates
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Enumeration Date | 04/27/2018
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 606 S SEVEN POINTS DR STE 9
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City | SEVEN POINTS
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State | TX
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Zip | 75143-9117
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Country | US
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Telephone | 214-666-6259
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Fax | 855-618-2235
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Provider Business Mailing Address
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Address Line | 8195 CUSTER RD STE 110
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City | FRISCO
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State | TX
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Zip | 75035-3195
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Country | US
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Telephone | 214-666-6259
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Fax | 855-618-2235
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP137359
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License Number State | TX
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