Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 654932 | TX |
NPI | 1013296201 |
---|---|
Provider Name | Martha Mefferd |
First Address | Austin, TX 78746-5675 |
Second Address | Austin, TX 78746-5675 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2011 |
Last Update Date | 08/12/2015 |