Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP127684 | TX |
NPI | 1003294679 |
---|---|
Provider Name | Mindy Unrau |
First Address | Amarillo, TX 79106-1754 |
Second Address | Amarillo, TX 79106-1754 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2015 |
Last Update Date | 29/07/2015 |