Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | AP124873 | TX |
NPI | 1043604101 |
---|---|
Provider Name | Ms. Laura Ann Guerrero |
First Address | Austin, TX 78705-1006 |
Second Address | Austin, TX 78705-1006 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2015 |
Last Update Date | 11/07/2016 |