Provider Demographics
NPI:1124847397
Name:CARSON, EMMA MEREDITH (RN, BSN, CCRN)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:MEREDITH
Last Name:CARSON
Suffix:
Gender:F
Credentials:RN, BSN, CCRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3908 KIVET CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46235-1808
Mailing Address - Country:US
Mailing Address - Phone:801-897-8609
Mailing Address - Fax:
Practice Address - Street 1:3908 KIVET CT
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46235-1808
Practice Address - Country:US
Practice Address - Phone:801-897-8609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28230560A163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice