Provider Demographics
NPI:1346203353
Name:CARLSON, NANCY COHN (MD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:COHN
Last Name:CARLSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 S JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-5635
Mailing Address - Country:US
Mailing Address - Phone:303-757-3292
Mailing Address - Fax:
Practice Address - Street 1:2121 S ONEIDA ST
Practice Address - Street 2:SUITE 200
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-2549
Practice Address - Country:US
Practice Address - Phone:303-757-6418
Practice Address - Fax:303-757-2209
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO28671208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0286715Medicaid