Individual
JACQUELINE MARGARET CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
45 VASSAR PL, LYNBROOK, NY 11563-1321
(516) 887-0305
Mailing address
45 VASSAR PL, LYNBROOK, NY 11563-1321
(516) 887-0305
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
592527
NY
Other
Enumeration date
07/27/2023
Last updated
07/27/2023
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