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DANIELLE LAUREN CARLSON CRNA

Physician Assistants & Advanced Practice Nursing Providers Nurse Anesthetist, Certified Registered

Provider NPI: 1700296324

Provider Information:
 DANIELLE LAUREN CARLSON CRNA
Gender: F
Not Sole Proprietor

Practice Location:
5734 COVENTRY LANE  FORT WAYNE, IN 47804-7141 US
Tel: 260-436-7875  Fax: 260-432-9812

Business Mailing Address:
609 S HOWELL AVE  WEST PLAINS, MO 65775-3747 US
Tel: 636-233-2266  Fax: --

NPI Information:
NPI: 1700296324
Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y367500000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Anesthetist, Certified Registered
MO100169

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 367500000X

Type:

Classification:



Definition:



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