Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | AP144698 | TX |
NPI | 1003446428 |
---|---|
Provider Name | Denise Lynn Austin |
First Address | Weatherford, TX 76086-1479 |
Second Address | Weatherford, TX 76086-4834 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2020 |
Last Update Date | 24/01/2020 |