Glen E. Carlsson, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

AP30008038 Issued in WA

Practice address

Madigan Army Medical Center 9040 Jackson Ave
Tacoma, WA 98431-0001

Phone

(253) 968-2235

NPI assigned

Oct 22, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Eric Elsemore Crna LLC

  • Certified Registered Nurse Anesthetist
  • North Bend, WA
  • NPI 1699073635

  Nurse Anesthetist, Certified Registered

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562889600000",
    "number": "1992994347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MADIGAN ARMY MEDICAL CENTER",
            "address_2": "9040 REID ST.",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "253-968-2252",
            "fax_number": "253-968-3278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "253-968-2235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSSON",
        "first_name": "GLEN",
        "middle_name": "E.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-22",
        "last_updated": "2019-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP30008038",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WV",
            "license": "AP30008038",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark David Carlson, MS DDS
• Nathan Howard Carlson, DPT
• Paul John Carlson, BA
• Ronda Carlson, AAS-HIS
• William J Carlson, DDS
• Susan Carlstrom, R.N.
• Diane Carlton
• Madeline Carlyle
• Margaret Joelle Carmack, LPN
• Carmen Catzoela

• Certified Registered Nurse Anesthetist in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Certified Registered Nurse Anesthetist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.