Individual
MRS. KRISTINA RAE CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MSN, NP-C
Contact information
Practice address
625 N. JACKSON AVENUE, SPRINGFIELD, MN 56087
(877) 412-7575
Mailing address
625 N. JACKSON AVENUE, SPRINGFIELD, MN 56087
(877) 412-7575
(507) 723-6447
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1502
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R1748934
RN
MN
Enumeration date
07/18/2013
Last updated
08/25/2020
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