Doctor Name: | AUDRA HOHEISEL |
NPI Number: | 1134587231 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | AP130068 |
Business Practice Address: | 1503 W Magnolia Ave Suite B Ft Worth, TX - 761044345 |
Business Phone Number: | 8175221530 |
Business Fax Number: | 8175238667 |
Mailing Address: | 1503 W Magnolia Ave, Suite B FT WORTH |
State: | TX |
Postal Code: | 761044345 |
Phone Number: | 8175221530 |
Fax Number: | 8175238667 |
NPI Enumeration Date: | 02/03/2016 |
NPI Last Update Date: | 02/03/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | AP130068 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |