Provider Demographics
NPI:1619636628
Name:CARLSON, DONNA SUZANNE (FNP)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:SUZANNE
Last Name:CARLSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10001 W BELL RD STE 105
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351-1283
Mailing Address - Country:US
Mailing Address - Phone:232-264-2446
Mailing Address - Fax:415-252-7176
Practice Address - Street 1:10001 W BELL RD STE 105
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-1283
Practice Address - Country:US
Practice Address - Phone:232-264-2446
Practice Address - Fax:415-252-7176
Is Sole Proprietor?:No
Enumeration Date:2021-12-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ267086363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily