Individual
COLLEEN PEARLE CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 E 3RD ST, DULUTH, MN 55805-1951
(218) 786-8364
Mailing address
400 E 3RD ST, DULUTH, MN 55805-1951
(218) 786-8364
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
1347
MN
363LP0200X
Pediatric Nurse Practitioner
R1030587
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
723718900
—
MN
Enumeration date
06/28/2006
Last updated
10/08/2020
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