NPI age
14 years
Enumerated 2011-06-16
Across 5095 active nurse practitioner providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (IL) | 043103013 | |
| 05 (MO) | 2009039423 | |
| 01 (IL) | 043103013 | BLUE CROSS BLUE SHIELD |
Part of a multi-provider practice. 12 other active providers share this practice address in NPPES.
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