Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 1-159559 | AL |
NPI | 1013562545 |
---|---|
Provider Name | Meagan Carson |
First Address | Helena, AL 35080-4012 |
Second Address | Helena, AL 35080-4012 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2019 |
Last Update Date | 12/09/2019 |