Provider Demographics
NPI:1669914248
Name:CARLSEN, ERIN
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:CARLSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1406 6TH AVE N
Mailing Address - Street 2:HEART & VASCULAR CENTER
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-1900
Mailing Address - Country:US
Mailing Address - Phone:320-656-7020
Mailing Address - Fax:320-255-5714
Practice Address - Street 1:1406 6TH AVE N
Practice Address - Street 2:HEART & VASCULAR CENTER
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-1900
Practice Address - Country:US
Practice Address - Phone:320-656-7020
Practice Address - Fax:320-255-5714
Is Sole Proprietor?:No
Enumeration Date:2016-11-14
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCNP 4876363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily