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NPI Code Detail

MEDICARE: TONI ANN CARLSEN

MEDICARE: TONI ANN CARLSEN
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
1174400000XSpecialist

General Provider Information

NPI Number : 1164148979
Entity Type Code : Individual
Provider Name (Legal Business Name) : TONI ANN CARLSEN
Provider Business Mailing Address
First Line : 659 PICKLED PEPPER PL
Second Line :
City : HENDERSON
State : NV
Zip : 89011-5510
Country : US
Telephone Number : 702-981-9494
Fax Number :
Provider Business Practice Location Address
First Line : 5576 S FORT APACHE RD STE 120
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-3607
Country : US
Telephone Number : 518-926-8338
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2022
Last Update Date : 10/13/2022

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Directions to “ TONI ANN CARLSEN ” Practice Location

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