Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | AP128661 | TX |
NPI | 1013385624 |
---|---|
Provider Name | Vanessa Frassati |
First Address | Georgetown, TX 78626-6821 |
Second Address | Austin, TX 78704-7192 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2015 |
Last Update Date | 24/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00R945 | MEDICARE (01) | TX |
138708611 | (05) | TX |
138708613 | (05) | TX |