Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | AP117386 | TX |
NPI | 1003224528 |
---|---|
Provider Name | Elizabeth A Hallman |
First Address | San Antonio, TX 78229-3901 |
Second Address | San Antonio, TX 78229-4402 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2014 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
378314401 | (05) | TX |
378314402 | CSHCN (01) | TX |