Individual
AMANDA LYN CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APRN, FNP-C
Contact information
Practice address
1340 NW WALL ST, BEND, OR 97703-1985
(541) 322-7500
(541) 322-7565
Mailing address
2577 NE COURTNEY DR, BEND, OR 97701-7752
(541) 322-7500
(541) 322-7565
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
10286389-3102
UT
363LF0000X
Family Nurse Practitioner
Primary
202109536NP-PP
OR
Other
Enumeration date
06/02/2020
Last updated
11/28/2023
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