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NPI Code Detail

MEDICARE: AMY ELIZABETH VANDER VORSTE FNP-C

MEDICARE: AMY ELIZABETH VANDER VORSTE FNP-C
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
1363LF0000XFamily Nurse Practitioner1084540TX

General Provider Information

NPI Number : 1952929366
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY ELIZABETH VANDER VORSTE FNP-C
Provider Business Mailing Address
First Line : 1910 ROSELAND BLVD
Second Line :
City : TYLER
State : TX
Zip : 75701-4246
Country : US
Telephone Number : 903-533-0644
Fax Number :
Provider Business Practice Location Address
First Line : 1910 ROSELAND BLVD
Second Line :
City : TYLER
State : TX
Zip : 75701-4246
Country : US
Telephone Number : 903-533-0644
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2020
Last Update Date : 03/17/2026

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Directions to “ AMY ELIZABETH VANDER VORSTE FNP-C” Practice Location

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