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Individual

JEANETTE LYNN CARLSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1420 N 10TH ST, SPEARFISH, SD 57783-1532
(605) 717-8595
Mailing address
913 ARTHUR ST, WHITEWOOD, SD 57793-3045
(605) 645-1836

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CP001108
SD

Other

Enumeration date
07/15/2016
Last updated
07/15/2016
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