Carson, Joann L

Carson, Joann L is an sole proprietor health care provider with primary practice located at 160 Clinic Ave , Carrollton GA 30117-4451. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Carson, Joann L can be contacted via phone (770) 834-1008.

Contact Information

Primary practice address
160 Clinic Ave Carrollton GA 30117-4451
Phone: (770) 834-1008
Fax: (770) 834-2531
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X RN130954CRNA Georgia

Profile Details

NPI number 1194795047
LBN Legal business name Carson, Joann L
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 24th, 2006
Last updated May 11th, 2012 - about 14 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 1194795047 NPPES
Georgia Other 374945 B CROSS
Georgia Other 000716394D B CROSS
Georgia MEDICAID 000716394I B CROSS
Georgia MEDICAID 000716394J B CROSS

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