BRENNA NICOLE CARLSON (NPI# 1689201113) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689201113 |
| Entity Type | Individual |
| Full Name | BRENNA NICOLE CARLSON |
| Credential | PA-C |
| Practice Address |
2510 Bellevue Medical Center Dr Ste 145a Bellevue NE 68123-1556 |
| Practice Telephone | 4027797207 |
| Practice Fax Number | 4027797210 |
| Mailing Telephone | 4027797841 |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2020-09-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
2522 | NE | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NE | 10025944600 | 05 |
| Street Address |
2510 BELLEVUE MEDICAL CENTER DR STE 145A |
| City | BELLEVUE |
| State | NE |
| Zip Code | 68123-1556 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619927282 | Loretta R Tibbels | Family Medicine | 2510 Bellevue Medical Center Dr Ste 145a, Bellevue, NE 68123-1556 | 2006-05-12 |
| 1619490380 | Skyler Kristine Jesz | Physician Assistant | 2510 Bellevue Medical Center Dr Ste 145a, Bellevue, NE 68123 | 2017-07-25 |
| 1528483096 | Alma Ramos-gilbert | Social Worker | 2510 Bellevue Medical Center Dr Ste 145a, Bellevue, NE 68123-1520 | 2014-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407482227 | Gloria Pettigrew-fletcher | Community Health Worker | 12432 A 36th St, C20, Bellevue, NE 68123 | 2020-03-13 |
| 1225480676 | Heidi Jean Mccoy | Dentist | 2110 Towne Centre Drive, Bellevue, NE 68123 | 2016-07-11 |
| 1538557442 | Mariam Abdelghany I | Physician Assistant | 2500 Bellevue Medical Center Drive, Bellevue, NE 68123 | 2014-12-30 |
| 1205243367 | Sara Johnson | Pharmacist | 3614 Twin Creeks Drive, Bellevue, NE 68123 | 2014-07-21 |
| 1174826747 | Francine Amy Drummond | Dentist | 1701 Independence Lane #22, Bellevue, NE 68123 | 2010-12-21 |
| 1053509588 | Dunlow Orthodontics, P.C. | Dentist | 2219 Capehart Road, Suite 102, Bellevue, NE 68123 | 2007-10-10 |
| 1801911870 | Michelle Lynn Gaeth | Dentist | 11536 S. 31st St., Bellevue, NE 68123 | 2007-03-20 |
| 1386789832 | Mary Monique Rotert | Psychologist | 3308 Samson Way Road, Suite 211, Bellevue, NE 68123 | 2007-02-21 |
| 1316084098 | Kevin B Jones | Family Medicine | 3308 Samson Way Ste 102, Bellevue, NE 68123 | 2007-01-31 |
| 1467529727 | Nebraska Medical Center | Pharmacy | 2510 Bellevue Medical Center Drive, Suite 100, Bellevue, NE 68123 | 2006-11-29 |
| Find all providers in zip 68123 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487066130 | Neon Corpuz | Physician Assistant | 4932 163rd Pl Se, Bellevue, WA 98006-4733 | 2014-05-29 |
| 1558601450 | Shannon Nicole Buster | Physician Assistant | 3503 Samson Way Ste 108, Bellevue, NE 68123-4303 | 2013-03-01 |
| 1407124407 | Natalya Vlaskin | Physician Assistant | 3900 Factoria Blvd Se Ste A, Bellevue, WA 98006-1234 | 2011-12-05 |
| 1831230911 | Nancy L Clark | Physician Assistant | 13033 Bellevue Redmond Rd, #110, Bellevue, WA 98005-2633 | 2007-02-09 |
| 1649326273 | Gary N Wellman | Physician Assistant | 301 116th Ave Se Ste 105, Suite #250, Bellevue, WA 98004-6482 | 2007-01-26 |
| 1164503314 | Bryna Dunaway Mccollum | Physician Assistant | 13231 Se 36th St Ste 110, Bellevue, WA 98006-7321 | 2006-10-17 |
| 1356871404 | Nicole B Bazar | Physician Assistant | 11511 Ne 10th St, Bellevue, WA 98004-8578 | 2017-06-12 |
| 1861840332 | Miguel A Escalera | Physician Assistant | 1427 116th Ave Ne, Bellevue, WA 98004-3807 | 2016-05-25 |
| 1538516927 | Rachel I Drayer | Physician Assistant | 11511 Ne 10th St, Bellevue, WA 98004 | 2016-05-16 |
| 1962838516 | Jana Soltero | Physician Assistant | 10400 Ne 4th St Ste 2250, Bellevue, WA 98004-5186 | 2013-09-15 |
| Find all providers in BELLEVUE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.