Jennifer Annette Carlson, CFY
Individual provider Active NPI Speech-Language Pathologist · Baxter, MN
NPI 1780107946 · NPPES record last updated Jul 19, 2017
Key facts
- NPI
- 1780107946
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 9929 (MN)
- Practice address
- 15620 Edgewood Dr Ste 240
Baxter, MN 56401-6984 - Phone
- (218) 454-7012
- Fax
- (218) 454-7015
- NPI assigned
- Jul 19, 2017
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9929 | MN | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 9929 | MN | Yes |
Addresses
Primary practice location
15620 Edgewood Dr Ste 240
Baxter, MN 56401-6984
Mailing address
309 Washington Ave
Ortonville, MN 56278-1357
Phone (320) 839-4090
Other providers in Baxter, MN
- Laura Ann Bye
- Taylor J Cadwell
- Randy Thomas Capelle
- Marc Anthony Carley
- Alletha Carlson
- Laura Carlson
- Sara Carlson
- Cedarbrook Community Services
- Centracare Clinic
- Julie Marie Christensen
All providers in Baxter, MN · Speech-Language Pathologist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 19, 2017. 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.