Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LN0000X | Nurse Practitioner - Neonatal | AP136820 | TX |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | AP136820 | TX |
NPI | 1265949986 |
---|---|
Provider Name | Andrea Kathryn Vance |
First Address | Austin, TX 78705-1006 |
Second Address | Austin, TX 78705-1006 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2018 |
Last Update Date | 21/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
885764 | REGISTERED NURSE (01) | TX |
885764 | RN (01) | TX |
AP136820 | APRN (01) | TX |