Individual
THERESA CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
4708 ALLIANCE BLVD STE 600, PLANO, TX 75093-5368
(469) 467-0011
(469) 467-4923
Mailing address
4708 ALLIANCE BLVD STE 600, PLANO, TX 75093-5368
(469) 467-0011
(469) 467-4923
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
AP129474
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
360325001
—
TX
05
—
360325002
—
TX
Enumeration date
10/29/2015
Last updated
07/13/2020
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