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General NPI Number Information
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NPI Number | 1235774571
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Entity Type | Individual
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Provider Name | KRISTEN ANNE CARLSON NP
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Gender | Female
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Dates
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Enumeration Date | 11/11/2019
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Last Update Date | 07/09/2024
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Provider Practice Location Address
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Address Line | 600 GRESHAM DR STE 8600
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City | NORFOLK
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State | VA
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Zip | 23507-1904
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Country | US
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Telephone | 757-388-6005
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Fax | 757-388-6006
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Provider Business Mailing Address
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Address Line | 600 GRESHAM DR STE 8600
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City | NORFOLK
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State | VA
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Zip | 23507-1904
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Country | US
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Telephone | 757-388-6005
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Fax | 757-388-6006
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 0024182824
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 0024182824
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 0001276051
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | RN.417855
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License Number State | OH
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