MRS. SUSAN RENEE CARLSON MSN ANP NPI 1043266711

NPI Information

NPI: 1043266711
Provider Name: MRS. SUSAN RENEE CARLSON, MSN, ANP
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

PECOS Registration: Yes

Address:
2740 N HWY 360
SUITE 100
GRAND PRAIRIE, TX
ZIP 75050
Phone: (972) 606-8300
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MRS. Susan Renee Carlson, MSN, ANP is an adult health nurse practitioner in Grand Prairie, TX. MRS. Susan Renee Carlson, MSN, ANP NPI is 1043266711. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2740 N HWY 360
SUITE 100
GRAND PRAIRIE, TX
ZIP 75050-403
Phone: (972) 606-8300
Fax: (972) 606-4940

The NPI 1043266711 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/25/2006 and was last updated on 2/23/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363L00000X	Nurse Practitioner		565581	TEXAS	No
2	363LA2200X	Nurse Practitioner	Adult Health	565581	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	156976601	MEDICAID	TEXAS
2	8A3462	MEDICARE PIN	TEXAS
3	P79875	MEDICARE UPIN	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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