Provider Demographics
NPI:1073613386
Name:CARLSON, AIMEE (CPNP)
Entity Type:Individual
Prefix:MRS
First Name:AIMEE
Middle Name:
Last Name:CARLSON
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4410 MEDICAL DR STE 550
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3755
Mailing Address - Country:US
Mailing Address - Phone:210-575-2222
Mailing Address - Fax:
Practice Address - Street 1:4410 MEDICAL DR STE 550
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3755
Practice Address - Country:US
Practice Address - Phone:210-575-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP112865363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner