Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | 636431 | TX |
NPI | 1013019983 |
---|---|
Provider Name | Ms. Elizabeth Ewng Weeks |
First Address | Kerrville, TX 78028-5768 |
Second Address | Kerrville, TX 78028-5768 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2006 |
Last Update Date | 08/07/2007 |