Provider Demographics
NPI:1639978455
Name:CARLSON, ELIZABETH J
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:J
Last Name:CARLSON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:J
Other - Last Name:SCHUTTLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:815 E 37TH ST
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68847-3207
Mailing Address - Country:US
Mailing Address - Phone:402-369-2822
Mailing Address - Fax:
Practice Address - Street 1:815 E 37TH ST
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-3207
Practice Address - Country:US
Practice Address - Phone:402-369-2822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion