Individual
TIMOTHY DREW CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
1015 DUPONT RD, LOUISVILLE, KY 40207-4610
(502) 883-0227
Mailing address
10500 WATERMARK PL APT 109, LOUISVILLE, KY 40223-0151
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1153868
KY
363LA2100X
Acute Care Nurse Practitioner
Primary
4035311
KY
Other
Enumeration date
01/08/2025
Last updated
02/12/2025
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