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Contact Information

SHANE CARLLSON, RN
829 CHEIF EDDIE HOFFMAN HWY
BETHEL, AK99559
 Phone: 907-549-6809
 Fax: 907-543-7110
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Registered Nurse

163W00000X
Indicates primary specialty

NPI Profile & details for SHANE CARLLSON · (Male)

NPI Number 1861823106
Status Active
Credentials RN (Registered Nurse)
Entity Individual
Enumeration date 12/12/2013
Last updated 12/12/2013 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • AK License # 27765
  • AK Medicaid 1020986
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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