Bronson, Carly Anne

Bronson, Carly Anne is an sole proprietor health care provider with primary practice located at 41820 Garstin Dr. , Big Bear Lake CA 92315. She recently has 2 registered licenses in different health care specialties including Hospitals / General Acute Care Hospital, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Bronson, Carly Anne can be contacted via phone (909) 878-8246.

Contact Information

Primary practice address
41820 Garstin Dr. Big Bear Lake CA 92315
Phone: (909) 878-8246
Fax: (909) 878-8294
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Hospitals / General Acute Care Hospital 282N00000X 101-0033221 Vermont
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 060326-23 New Hampshire
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X COA.12102-NP Ohio
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 95001879 California

Profile Details

NPI number 1962628719
LBN Legal business name Bronson, Carly Anne
Credentials R.N., NP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 18th, 2007
Last updated Aug 3rd, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962628719 NPPES
Vermont MEDICAID 1013302
Vermont MEDICAID 1013302
Vermont MEDICAID 19626228719

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