Provider Demographics
NPI:1174688873
Name:CARLSON, GAIL CHRISTINE (RN, BSN)
Entity Type:Individual
Prefix:MISS
First Name:GAIL
Middle Name:CHRISTINE
Last Name:CARLSON
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4536 COLFAX AVE S
Mailing Address - Street 2:# 2
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55419-4737
Mailing Address - Country:US
Mailing Address - Phone:612-823-3679
Mailing Address - Fax:
Practice Address - Street 1:4536 COLFAX AVE S
Practice Address - Street 2:# 2
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55419-4737
Practice Address - Country:US
Practice Address - Phone:612-823-3679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 107321-4163WA0400X, 163WH0500X, 163WI0500X, 163WP0808X, 163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
Not Answered163WH0500XNursing Service ProvidersRegistered NurseHemodialysis
Not Answered163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
Not Answered163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Not Answered163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care