Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | AP30007452 | WA |
NPI | 1023128980 |
---|---|
Provider Name | Arlene M Zwald |
First Address | Marble Falls, TX 78654-3622 |
Second Address | Round Rock, TX 78664-3289 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 17/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0212378 | L&I (01) | WA |
9650417 | (05) | WA |
Q72010 | (02) | WA |