Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP128641 | TX |
NPI | 1003286600 |
---|---|
Provider Name | Nena Tiukinhoy |
First Address | San Antonio, TX 78229-4551 |
Second Address | San Antonio, TX 78251-1437 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2015 |
Last Update Date | 27/09/2017 |