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Individual

CARLA MICHELLE CARLSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LVN

Contact information

Practice address
4100 MAJESTIC CT, FORT WORTH, TX 76244-8678
(817) 875-7098
Mailing address
4100 MAJESTIC CT, FORT WORTH, TX 76244-8678
(817) 875-7098

Taxonomy

Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
195526
TX

Other

Enumeration date
04/03/2018
Last updated
04/03/2018
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