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General NPI Number Information
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NPI Number | 1609533504
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Entity Type | Individual
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Provider Name | FELICIA DAWN CARLSON FNP
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Gender | Female
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Dates
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Enumeration Date | 11/26/2021
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Last Update Date | 11/26/2021
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Provider Practice Location Address
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Address Line | 17065 US-71
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City | BELTON
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State | MO
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Zip | 64012
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Country | US
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Telephone | 816-605-9758
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Fax |
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Provider Business Mailing Address
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Address Line | 10214 N QUINCY AVE
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City | KANSAS CITY
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State | MO
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Zip | 64156-3129
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Country | US
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Telephone | 913-337-8700
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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 | F11210271
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License Number State | MO
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