Individual
MRS. KATIE CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8840 CALUMET AVE, SUITE 103, MUNSTER, IN 46321-2545
(219) 836-7246
Mailing address
2741 W LAYTON AVE STE 106, MILWAUKEE, WI 53221-2600
(414) 242-5468
(888) 724-0875
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002162A
IN
Other
Enumeration date
11/23/2016
Last updated
09/20/2019
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