Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | AP144843 | TX |
NPI | 1033751672 |
---|---|
Provider Name | Natasha Bing |
First Address | Conroe, TX 77385-1129 |
Second Address | Conroe, TX 77385-1129 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2019 |
Last Update Date | 03/02/2020 |