Carlson, Susan Renee

Carlson, Susan Renee is an individual health care provider with primary practice located at 2740 N Hwy 360 Suite 100, Grand Prairie TX 75050-6403. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Adult Health. Physician Assistants & Advanced Practice Nursing Providers / Adult Health is her primary health care specialty. Carlson, Susan Renee can be contacted via phone (972) 606-8300.

Contact Information

Primary practice address
2740 N Hwy 360 Suite 100 Grand Prairie TX 75050-6403
Phone: (972) 606-8300
Fax: (972) 606-4940
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 565581 Texas
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 565581 Texas

Profile Details

NPI number 1043266711
LBN Legal business name Carlson, Susan Renee
Credentials MSN, ANP
Entity Individual
Sole proprietor 1 No
Enumeration date May 25th, 2006
Last updated Feb 23rd, 2010 - about 14 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 1043266711 NPPES
Texas MEDICAID 156976601

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