Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | AP135001 | TX |
NPI | 1023536612 |
---|---|
Provider Name | Olena Shvets |
First Address | San Antonio, TX 78258-4213 |
Second Address | San Antonio, TX 78215-2012 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2017 |
Last Update Date | 02/09/2017 |