Individual
MRS. MARTHA ALEISA CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP
Contact information
Practice address
580 NEW WAVERLY PL, SUITE 120, CARY, NC 27518-7406
(919) 858-8360
(919) 858-8408
Mailing address
580 NEW WAVERLY PL, SUITE 120, CARY, NC 27518-7406
(919) 858-8360
(919) 858-8408
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
5007916
NC
367A00000X
Advanced Practice Midwife
99045
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30487749
—
CO
01
—
CA658010
BLUE CROSS BLUE SHIELD
CO
Enumeration date
01/23/2006
Last updated
05/19/2016
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