| NPI | 1811599798 |
|---|---|
| Former Name | DANIELLE LEE CARLSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1023845) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2466627) |
| Enumeration Date | 2020-11-15 |
| Last Update Date | 2023-10-22 |