Provider Demographics
NPI:1780341529
Name:CARSON, ANDREA DAWN (DOULA, LPN)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:DAWN
Last Name:CARSON
Suffix:
Gender:F
Credentials:DOULA, LPN
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:DAWN
Other - Last Name:CARSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DOULA, LPN
Mailing Address - Street 1:7709 QUEENS PARK RD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-1924
Mailing Address - Country:US
Mailing Address - Phone:443-790-9767
Mailing Address - Fax:
Practice Address - Street 1:7709 QUEENS PARK RD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-1924
Practice Address - Country:US
Practice Address - Phone:443-790-9767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-29
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula