Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 2020-00717 | NC |
N | 207R00000X | Internist | 264159 | MA |
N | 111NI0900X | Internist | 264159 | MA |
NPI | 1073993788 |
---|---|
Provider Name | Elise R Coulson |
First Address | Charlotte, NC 28260-3725 |
Second Address | Asheville, NC 28801-4104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2015 |
Last Update Date | 02/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1073993788 | (05) | NC |