Provider Demographics
NPI:1417784513
Name:CARLSON, ALLISON (DEM)
Entity type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:
Last Name:CARLSON
Suffix:
Gender:F
Credentials:DEM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:928 W 280 N
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-4534
Mailing Address - Country:US
Mailing Address - Phone:480-347-8675
Mailing Address - Fax:
Practice Address - Street 1:1883 N 1120 W
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-1180
Practice Address - Country:US
Practice Address - Phone:801-724-1604
Practice Address - Fax:385-225-9306
Is Sole Proprietor?:No
Enumeration Date:2024-09-14
Last Update Date:2024-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife