MEDICARE: NICOLE ASHLEY CARLSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1023824422
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE ASHLEY CARLSON

Provider Business Mailing Address
First Line	:	221 N 5TH ST
Second Line	:
City	:	PIERCE
State	:	NE
Zip	:	68767-1203
Country	:	US
Telephone Number	:	402-841-7906
Fax Number	:

Provider Business Practice Location Address
First Line	:	221 N 5TH ST
Second Line	:
City	:	PIERCE
State	:	NE
Zip	:	68767-1203
Country	:	US
Telephone Number	:	402-841-7906
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/10/2024
Last Update Date	:	12/10/2024

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Directions to “ NICOLE ASHLEY CARLSON ” Practice Location

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