Individual
CINNAMON LEE CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
200 SAN SEBASTIAN VW, ST AUGUSTINE, FL 32084-8695
(904) 209-6200
Mailing address
2621 E JEFFERSON ST, WARSAW, IN 46580-3880
(574) 267-7169
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
9196197
FL
Other
Enumeration date
02/06/2018
Last updated
05/13/2021
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