Provider Demographics
NPI:1699401307
Name:MASON, CAROL DENISE (WHNP-BC)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:DENISE
Last Name:MASON
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62200 WESTEND BLVD APT 8103
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70461-5631
Mailing Address - Country:US
Mailing Address - Phone:601-622-8757
Mailing Address - Fax:
Practice Address - Street 1:466 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36604-1960
Practice Address - Country:US
Practice Address - Phone:160-162-2875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-26
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-33058363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health