Individual
KYLA M. CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
2400 CEDAR BEND DR, AUSTIN, TX 78758-5378
(512) 901-4031
(512) 901-3937
Mailing address
12221 N MOPAC EXPY, AUSTIN, TX 78758-2401
(512) 901-4031
(512) 901-3937
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
763905
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
332828801
—
TX
Enumeration date
12/11/2013
Last updated
02/04/2022
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