Provider Demographics
NPI:1851095830
Name:CARLSON, AMY ROSE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:ROSE
Last Name:CARLSON
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 1:813 SIGSBEE RD
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-6700
Mailing Address - Country:US
Mailing Address - Phone:931-572-4566
Mailing Address - Fax:
Practice Address - Street 1:3134 NORTHSIDE DR
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-8004
Practice Address - Country:US
Practice Address - Phone:305-294-8441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11024690363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily