Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 654524 | TX |
NPI | 1003049214 |
---|---|
Provider Name | Mrs. Kristie Anguiano |
First Address | Corpus Christi, TX 78410 |
Second Address | Corpus Christi, TX 78410 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/09/2009 |
Last Update Date | 16/03/2016 |