Doctor Name: | BRITTNEY ANN MISERCOLA |
NPI Number: | 1104178037 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | 588871 |
Business Practice Address: | 3816 S Clear Creek Rd Suite B Killeen, TX - 765494400 |
Business Phone Number: | 5124857200 |
Business Fax Number: | 5124857220 |
Mailing Address: | 4100 Duval Rd, Bldg 3 Suite 200 AUSTIN |
State: | TX |
Postal Code: | 787593550 |
Phone Number: | 5124857200 |
Fax Number: | 5124857220 |
NPI Enumeration Date: | 10/02/2012 |
NPI Last Update Date: | 12/18/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 588871 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |