Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | AP142909 | TX |
Y | 363LA2200X | Nurse Practitioner - Adult Health | AP142909 | TX |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | AP142909 | TX |
N | 363LG0600X | Nurse Practitioner - Gerontology | AP142909 | TX |
NPI | 1447809884 |
---|---|
Provider Name | Anthony Viscon |
First Address | El Paso, TX 79902-2140 |
Second Address | El Paso, TX 79911 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2019 |
Last Update Date | 09/09/2019 |