MEDICARE: MISS SARAH STAGG CARSON MSN, FNP-C

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	363LF0000X	Family Nurse Practitioner	748306	TX

General Provider Information

NPI Number	:	1467740795
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS SARAH STAGG CARSON MSN, FNP-C

Provider Business Mailing Address
First Line	:	2105 E MARTIN LUTHER KING JR BLVD STE 305
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78702-1341
Country	:	US
Telephone Number	:	512-787-5747
Fax Number	:	866-397-1206

Provider Business Practice Location Address
First Line	:	2105 E MARTIN LUTHER KING JR BLVD STE 305
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78702-1341
Country	:	US
Telephone Number	:	512-787-5747
Fax Number	:	866-397-1206

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

Provider Enumeration Date	:	07/20/2011
Last Update Date	:	10/15/2025

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