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General NPI Number Information
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NPI Number | 1114899648
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Entity Type | Individual
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Provider Name | ASHLEY RENEE CARLSON FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/23/2025
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 819 HIGHWAY 2 STE 216
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City | SANDPOINT
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State | ID
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Zip | 83864-1678
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Country | US
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Telephone | 209-677-7747
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Fax |
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Provider Business Mailing Address
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Address Line | 1038 23RD AVE SW
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City | ROCHESTER
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State | MN
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Zip | 55902-3449
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Country | US
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Telephone | 507-272-4568
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Fax |
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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 | 13597
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License Number State | MN
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