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General NPI Number Information
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NPI Number | 1750892741
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Entity Type | Individual
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Provider Name | MARIE MCDERMOTT CARLSON DNP, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/17/2017
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Last Update Date | 04/05/2023
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Provider Practice Location Address
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Address Line | 8550 SANTA MONICA BLVD FL 2
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90069-4496
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Country | US
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Telephone | 909-962-1260
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Fax |
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Provider Business Mailing Address
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Address Line | 8550 SANTA MONICA BLVD FL 2
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90069-4496
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Country | US
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Telephone | 909-962-1260
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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 | TPAN313
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 47645
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License Number State | WY
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 084907-23
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License Number State | NH
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 68512
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License Number State | ID
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F347968-01
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License Number State | NY
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Taxonomy #6
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | A168159
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License Number State | IA
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Taxonomy #7
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN-3283
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License Number State | HI
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Taxonomy #8
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024175214
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License Number State | VA
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Taxonomy #9
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 0024175214
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License Number State | VA
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