Individual
JETTE CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1024 S LEMAY AVE, FORT COLLINS, CO 80524-3929
(970) 237-7933
Mailing address
PO BOX 722, LAPORTE, CO 80535-0722
(970) 631-3396
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
183678
CO
Other
Enumeration date
08/14/2019
Last updated
08/14/2019
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