Tatyana Ygnacia Carlson, IDMT
Individual provider Active NPI Independent Duty Medical Technicians · Moody Afb, GA
NPI 1700560471 · NPPES record last updated Dec 13, 2023
Key facts
- NPI
- 1700560471
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Independent Duty Medical Technicians 1710I1003X
- Practice address
- 710 Vanguard Way
Moody Afb, GA 31699-8704 - Phone
- (229) 257-2778
- NPI assigned
- Jun 13, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hedera Counseling Center | Current |
Accepting new patients |
Locations
3280 Mitchell Blvd
Moody AFB, GA 31699
Phone (229) 257-2778
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Independent Duty Medical Technicians | 1710I1003X | Yes |
Addresses
Primary practice location
710 Vanguard Way
Moody Afb, GA 31699-8704
Mailing address
3280 Mitchell Blvd
Moody Afb, GA 31699-1500
Phone (229) 257-2778
Other providers in Moody Afb, GA
- Michelle D Brock
- Angela M Brown
- Heather Brown
- Michael J Butler
- Gordon H Campbell
- Jonica Carlton Best
- Michael Thomas Cartwright Sr.
- Courtney Leigh Carver
- Makayla Chamberlain
- Chase Chambers
All providers in Moody Afb, GA · Independent Duty Medical Technicians in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 13, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.