Provider Demographics
NPI:1063762300
Name:CARLSON, HANNAH ROSE (ARNP, NP-C)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:ROSE
Last Name:CARLSON
Suffix:
Gender:F
Credentials:ARNP, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 SE CABOT DR STE B102
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-3740
Mailing Address - Country:US
Mailing Address - Phone:360-675-5555
Mailing Address - Fax:360-675-0275
Practice Address - Street 1:1690 LAYTON RD
Practice Address - Street 2:
Practice Address - City:FREELAND
Practice Address - State:WA
Practice Address - Zip Code:98249
Practice Address - Country:US
Practice Address - Phone:360-331-1314
Practice Address - Fax:360-331-9703
Is Sole Proprietor?:No
Enumeration Date:2012-09-13
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60309969363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily