Provider Demographics
NPI:1548646995
Name:CARLSON, CHELSEA (PHARMD)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:CARLSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5100 PRAIRIE PKWY STE 106
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-8155
Mailing Address - Country:US
Mailing Address - Phone:319-222-2906
Mailing Address - Fax:319-222-2996
Practice Address - Street 1:1422 FLAMMANG DR
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50702-4368
Practice Address - Country:US
Practice Address - Phone:319-237-1774
Practice Address - Fax:319-233-4492
Is Sole Proprietor?:No
Enumeration Date:2015-08-08
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA22444183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist