Doctor Name: | CORA LEAH DZIUK |
NPI Number: | 1184925356 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN, MSN, NP-C |
License Number: | 669986 |
Business Practice Address: | 104 Turner Ln Floresville, TX - 781143171 |
Business Phone Number: | 8303933492 |
Business Fax Number: | 8303933424 |
Mailing Address: | 104 Turner Ln, FLORESVILLE |
State: | TX |
Postal Code: | 781143171 |
Phone Number: | 8303933492 |
Fax Number: | 8303933424 |
NPI Enumeration Date: | 11/04/2010 |
NPI Last Update Date: | 02/12/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 669986 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |