Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 0010-11426 | NC |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 0010-11426 | NC |
NPI | 1669140190 |
---|---|
Provider Name | Laura Nicole Carlson |
First Address | Biltmore Forest, NC 28803-2922 |
Second Address | Arden, NC 28704-9577 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2021 |
Last Update Date | 31/08/2021 |