Provider Demographics
NPI:1265444731
Name:CARLSON TUOHY, BETH A (APRN)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:A
Last Name:CARLSON TUOHY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 POST RD W
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-4701
Mailing Address - Country:US
Mailing Address - Phone:203-226-0731
Mailing Address - Fax:203-226-1792
Practice Address - Street 1:333 POST RD W
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-4701
Practice Address - Country:US
Practice Address - Phone:203-226-0731
Practice Address - Fax:203-226-1792
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001580363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTS74604Medicare UPIN
CT500001289Medicare ID - Type Unspecified