Individual
ALICE L CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.N.P.
Contact information
Practice address
1373 E STATE ROAD 62, MADISON, IN 47250-7328
(812) 801-0832
(812) 801-0759
Mailing address
PO BOX 189, MADISON, IN 47250-0189
(812) 801-0832
(812) 801-0759
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71000362
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000042220
ANTHEM BCBS
IN
05
—
200161100A
—
IN
01
—
500007922
MEDICARE RAILROAD
—
01
—
7500319
AETNA
—
Enumeration date
07/05/2006
Last updated
02/27/2013
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