Doctor Name: | ANNA SMITH |
NPI Number: | 1003229386 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NNP |
License Number: | AP126653 |
Business Practice Address: | 2609 Blake St Austin, TX - 787483950 |
Business Phone Number: | 5129231509 |
Business Fax Number: | |
Mailing Address: | 2609 Blake St, AUSTIN |
State: | TX |
Postal Code: | 787483950 |
Phone Number: | 5129231509 |
Fax Number: | |
NPI Enumeration Date: | 06/04/2014 |
NPI Last Update Date: | 04/29/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LN0000X |
License Number: | AP126653 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Neonatal |
Taxonomy Definition: |