Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | AP116908 | TX |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 692637 | TX |
Y | 363LP2300X | Nurse Practitioner - Primary Care | 692637 | TX |
NPI | 1043476971 |
---|---|
Provider Name | Amanda Apodaca Blancas |
First Address | El Paso, TX 79902-2921 |
Second Address | El Paso, TX 79902-2921 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2008 |
Last Update Date | 21/06/2017 |