Most Relevant Information
Provider Data
| NPI Number: | 1003658543 |
| Provider Name: | ALEXIS JO CARLSON APRN |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 938240-01 |
Most Important Dates
| Enumeration Date: | 06/06/2024 |
| Last Updated: | 10/14/2024 |
Provider Practice Location
40 FLATBUSH AVENUE EXT
BROOKLYN
NY
112012903
Practice Location Phone/Fax
| Phone: | 6465312723 |
| Fax: |
Provider Mailing Location
522 MADRONA WAY NE UNIT 3
BAINBRIDGE ISLAND
WA
981103281
Provider Mailing Phone/Fax
| Phone: | 2063351900 |
| Fax: |