Doctor Name: | MRS. LINDA JAN CARLSON |
NPI Number: | 1033217823 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP |
License Number: | 930872 |
Business Practice Address: | 2100 Summerfield Rd Winter Park, FL - 327925037 |
Business Phone Number: | 4076223200 |
Business Fax Number: | 4076223290 |
Mailing Address: | 606 La Salle Dr, ALTAMONTE SPRINGS |
State: | FL |
Postal Code: | 327141322 |
Phone Number: | 4077747758 |
Fax Number: | |
NPI Enumeration Date: | 09/20/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0200X |
License Number: | 930872 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |