Provider Demographics
NPI:1548402910
Name:CARLSSON, SHARON A (RN)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:A
Last Name:CARLSSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:SHARON
Other - Middle Name:A
Other - Last Name:SCHMIDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1521 SUMMIT DR
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-2545
Mailing Address - Country:US
Mailing Address - Phone:715-675-6488
Mailing Address - Fax:
Practice Address - Street 1:1521 SUMMIT DR
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-2545
Practice Address - Country:US
Practice Address - Phone:715-675-6488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-01
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI43186163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse