Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | AP132781 | TX |
NPI | 1013925429 |
---|---|
Provider Name | Mrs. Erica Burg |
First Address | Austin, TX 78766-1597 |
Second Address | Austin, TX 78705-2707 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2006 |
Last Update Date | 06/03/2017 |