MEDICARE: CERTIFIED NURSE PRACTITIONERS, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	239473	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194901413
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CERTIFIED NURSE PRACTITIONERS, PC

Provider Business Mailing Address
First Line	:	7005 MIRA LOMA LN STE 101
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78723-1411
Country	:	US
Telephone Number	:	512-300-2455
Fax Number	:

Provider Business Practice Location Address
First Line	:	7005 MIRA LOMA LN STE 101
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78723-1411
Country	:	US
Telephone Number	:	512-300-2455
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. MALCOLM DUNCAN
Credential	:	APRN, PMHNP-BC
Telephone Number	:	512-300-2455

Provider Enumeration Date	:	01/16/2008
Last Update Date	:	01/12/2026

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