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Jessica L Carlson
Military Health Care Provider in Coal Valley, Illinois
NPI 1205422011

Jessica L Carlson is a Military Health Care Provider based in Coal Valley, IL. Jessica L Carlson practices in Coal Valley, IL. The NPI Number for Jessica L Carlson is 1205422011 and holds a License No. (Illinois).

The current practice location address for Jessica L Carlson is 112 W 9Th St, Coal Valley, IL and can be reached out via phone at 309-644-2870.

Location: 112 W 9Th St, Coal Valley, IL, 61240-9120
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1205422011
Provider Name
Jessica L Carlson
Credential
Provider Entity Type
Individual
Gender
Female
Address
112 W 9Th St, Coal Valley, IL, 61240-9120
Phone Number
309-644-2870
Fax Number
Provider Enumeration Date
12/15/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
112 W 9Th St
City
Coal Valley
State
Illinois
Zip
61240-9120
Phone Number
309-644-2870
Fax Number
person
Provider Business Mailing Address Details
Address
112 W 9Th St
City
Coal Valley
State
Illinois
Zip
61240-9120
Phone Number
309-644-2870
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Military Health Care Provider
Speciality
-
Taxonomy
171000000X
License No.
(Iowa)
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
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