Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | AP131875 | TX |
Y | 363LP2300X | Nurse Practitioner - Primary Care | AP131875 | TX |
NPI | 1033652359 |
---|---|
Provider Name | Agnes Esop |
First Address | Fresno, TX 77545-8762 |
Second Address | Fresno, TX 77545-8762 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2016 |
Last Update Date | 23/11/2016 |