Individual provider · Type 1 NPI
Jessica L. Carlson
Military Health Care Provider · Coal Valley, IL
NPI number
1205422011
Active
Practice location
112 W 9th St
Coal Valley, IL 61240-9120
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Military Health Care Provider Primary | 171000000X | None listed |
Military Health Care Provider: Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
About NPI 1205422011
Jessica L. Carlson's National Provider Identifier is 1205422011, issued on Dec 15, 2020. The primary taxonomy on file is Military Health Care Provider (171000000X), and the practice location is in Coal Valley, IL. The record was last updated on Dec 15, 2020.