Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 637372 | TX |
NPI | 1023276052 |
---|---|
Provider Name | Andrea Denise Nemec |
First Address | Dallas, TX 75266-0599 |
Second Address | Waco, TX 76712-8897 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2008 |
Last Update Date | 26/12/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
196251601 | (05) | TX |
8Y8331 | BLUE CROSS BLUE SHIELD (01) | TX |