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NPI Code Detail

MEDICARE: MS. AMY ELIZABETH SOUDERS ACNP

MEDICARE: MS. AMY ELIZABETH SOUDERS ACNP
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
1363L00000XNurse PractitionerAP121287TX

General Provider Information

NPI Number : 1518225291
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. AMY ELIZABETH SOUDERS ACNP
Provider Business Mailing Address
First Line : PO BOX 845347
Second Line :
City : DALLAS
State : TX
Zip : 75284-7208
Country : US
Telephone Number : 214-633-5555
Fax Number :
Provider Business Practice Location Address
First Line : 6201 HARRY HINES BLVD
Second Line :
City : DALLAS
State : TX
Zip : 75235-5202
Country : US
Telephone Number : 214-633-5555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2012
Last Update Date : 02/05/2026

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