MEDICARE: ALICIA LENORE ZANDER APN FNP

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	694917	TX

General Provider Information

NPI Number	:	1578517017
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICIA LENORE ZANDER APN FNP

Provider Business Mailing Address
First Line	:	205 E UNIVERSITY AVE STE 200
Second Line	:
City	:	GEORGETOWN
State	:	TX
Zip	:	78626-6821
Country	:	US
Telephone Number	:	512-686-0207
Fax Number	:

Provider Business Practice Location Address
First Line	:	7000 WOODHUE DR BLDG B
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78745-5454
Country	:	US
Telephone Number	:	877-800-5722
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	07/17/2019

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