Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 808937 | TX |
NPI | 1033551270 |
---|---|
Provider Name | Ms. Lori Elizabeth Fox |
First Address | Austin, TX 78735-8827 |
Second Address | Austin, TX 78735-8827 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2013 |
Last Update Date | 02/08/2017 |