NPI 1205422011
Jessica L Carlson
Practice location
- Address
- 112 W 9th St, Coal Valley, IL 61240-9120
- Phone
- (309) 644-2870
Registered specialties
Military Health Care Provider
Primary
Registry record
- NPI
- 1205422011
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 15 Dec 2020
- Record last updated
- 15 Dec 2020
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.