Carlson, Jacqueline

Carlson, Jacqueline is an individual health care provider with primary practice located at 145 W 23Rd St , Erie PA 16502-2858. She recently has only one registered license in Dietary & Nutritional Service Providers / Nutrition, Metabolic, which is considered as her primary health care specialty. Carlson, Jacqueline can be contacted via phone (814) 835-2626.

Contact Information

Primary practice address
145 W 23Rd St Erie PA 16502-2858
Phone: (814) 835-2626
Fax: (814) 835-2646
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Nutrition, Metabolic 133VN1006X 000806 New York
Dietary & Nutritional Service Providers / Nutrition, Metabolic 133VN1006X DN006773 Pennsylvania

Profile Details

NPI number 1942291935
LBN Legal business name Carlson, Jacqueline
Credentials RD CDE
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 31st, 2005
Last updated Aug 15th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942291935 NPPES
New York Other 005261701 BLUE CROSS
New York Other 051101000071 BLUE CROSS

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