Individual
HEATHER LEILANIA CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
351 W CAMDEN ST, BALTIMORE, MD 21201-7912
(410) 625-2200
Mailing address
351 W CAMDEN ST, BALTIMORE, MD 21201-7912
(410) 625-2200
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
RN191800
GA
Other
Enumeration date
11/13/2014
Last updated
11/13/2014
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