Individual
TINA MARIE CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1105 SE JETTY AVE STE C, LINCOLN CITY, OR 97367-2604
(541) 614-0482
Mailing address
2D MANOR DR, HOOKSETT, NH 03106-1729
(907) 301-8302
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
076986-23
NH
Other
Enumeration date
04/11/2022
Last updated
04/11/2022
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