| Doctor Name: | MR. LEE CARLSON |
| NPI Number: | 1962841965 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | ARNP-C |
| License Number: | A118681 |
| Business Practice Address: | 1000 10th Ave Ackley, IA - 506011701 |
| Business Phone Number: | 6418472625 |
| Business Fax Number: | 6418472509 |
| Mailing Address: | 1000 10th Ave, ACKLEY |
| State: | IA |
| Postal Code: | 506011701 |
| Phone Number: | 6418472625 |
| Fax Number: | 6418472509 |
| NPI Enumeration Date: | 06/23/2013 |
| NPI Last Update Date: | 02/06/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | A118681 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |