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NPI Code Detail

MEDICARE: JORDAN ANN CARLSON

MEDICARE:   JORDAN ANN 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
11041C0700XClinical Social Worker28380MN

General Provider Information

NPI Number : 1629938410
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORDAN ANN CARLSON
Provider Business Mailing Address
First Line : 9531 W 78TH ST STE 220
Second Line :
City : EDEN PRAIRIE
State : MN
Zip : 55344-3863
Country : US
Telephone Number : 612-399-6020
Fax Number : 952-214-7490
Provider Business Practice Location Address
First Line : 9531 W 78TH ST STE 220
Second Line :
City : EDEN PRAIRIE
State : MN
Zip : 55344-3863
Country : US
Telephone Number : 612-399-6020
Fax Number : 952-214-7490
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2025
Last Update Date : 11/13/2025

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Directions to “ JORDAN ANN CARLSON ” Practice Location

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