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Breeannon Carlson
NPI 1992112486 · on the registry since 2014
Practice
- Address
- 5510 E State St
Rockford, IL 61108 - Phone
- (815) 395-4505
- Organisation at this address
- Saint Anthony Medical Center
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 40
Registry record
- Primary taxonomy
- 225100000X
225100000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2014-07-16
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois