Individual
ELLEN JANE CARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
3003 W DR MARTIN LUTHER KING JR BLVD, MS-3012, TAMPA, FL 33607-6307
(813) 870-4438
(813) 870-4153
Mailing address
1706 COTTAGESIDE CT, BRANDON, FL 33510-2747
(813) 654-0136
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
ARNP1123702
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005619700
—
FL
Enumeration date
11/30/2009
Last updated
11/21/2013
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