Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Carly P Pederson, ATC/R

Individual provider Athletic Trainer · NPI 1417394297

Carly P Pederson, ATC/R is an Athletic Trainer in Elk River, Minnesota. Licensed in Minnesota. Registered with an NPI since 2013.

Licensed in
MN
In the registry since
2013

Practice location Address checks out

18929 149th St NW
Elk River, MN 55330-8362
Phone: (612) 518-7270
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 2433 (MN)

Record details

NPI number1417394297
Entity typeIndividual (Type 1)
GenderFemale
Credentials ATC/R
Sole proprietorNo
NPI enumeratedJune 3, 2013
Last updated in NPPESApril 29, 2021
Certification dateApril 29, 2021

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