NPI age
14 years
Enumerated 2011-06-24
Across 22123 active nurse practitioner providers in Texas.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (KS) | 53-78721-121 | STATE LICENSE |
| 01 (MO) | 2019006675 | STATE LICENSE |
| 01 (TN) | APN15784 | STATE LICENSE |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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