Carrie Carlson, OTD, OTR/L

Individual provider Active NPI Community Health Worker · Cedar Rapids, IA

NPI 1780136200 · NPPES record last updated Nov 1, 2016

Key facts

NPI
1780136200
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Worker 172V00000X
License
00162 (IA)
Practice address
4608 Blarney Dr
Cedar Rapids, IA 52411-8069
Phone
(319) 290-1292
NPI assigned
Nov 1, 2016
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
00162IAMDCommunity Health Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X 00162 IA Yes

Addresses

Primary practice location

4608 Blarney Dr
Cedar Rapids, IA 52411-8069

Mailing address

4608 Blarney Dr
Cedar Rapids, IA 52411-8069
Phone (319) 290-1292

Other providers in Cedar Rapids, IA

All providers in Cedar Rapids, IA · Community Health Worker in Iowa

Sources for this page

Verify at the official NPI Registry.