Provider Demographics
NPI:1396789723
Name:CARSON, BARBARA ANN
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:CARSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10002 AURORA AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-9348
Mailing Address - Country:US
Mailing Address - Phone:207-576-3876
Mailing Address - Fax:
Practice Address - Street 1:115 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:SULPHUR SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:75482-2105
Practice Address - Country:US
Practice Address - Phone:903-885-9758
Practice Address - Fax:903-885-1052
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX727489367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV530953Medicare UPIN
TX8G4725Medicare ID - Type Unspecified