Individual
DANIELLE LAUREN CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
5734 COVENTRY LANE, FORT WAYNE, IN 47804-7141
(260) 436-7875
(260) 432-9812
Mailing address
609 S HOWELL AVE, WEST PLAINS, MO 65775-3747
(636) 233-2266
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
100169
MO
Other
Enumeration date
05/05/2014
Last updated
05/21/2014
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