Carlson, Ronell Jean

Carlson, Ronell Jean is an individual health care provider with primary practice located at 4222 Wendover Ave Suite 600, Odessa TX 79762-5945. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Carlson, Ronell Jean can be contacted via phone (432) 552-5656.

Contact Information

Primary practice address
4222 Wendover Ave Suite 600 Odessa TX 79762-5945
Phone: (432) 552-5656
Fax: (432) 552-0992
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 532880 Texas

Profile Details

NPI number 1245273325
LBN Legal business name Carlson, Ronell Jean
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2006
Last updated Oct 3rd, 2008 - about 16 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 1245273325 NPPES
Texas MEDICAID 164838801

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