Healthcare Provider Details

I. General information

NPI: 1245810811
Provider Name (Legal Business Name): ANNELIESE HULSE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNELIESE GREY

II. Dates (important events)

Enumeration Date: 04/08/2021
Last Update Date: 03/22/2022
Certification Date: 07/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 W ADOUE ST
ALVIN TX
77511-2718
US

IV. Provider business mailing address

1111 W ADOUE ST
ALVIN TX
77511-2718
US

V. Phone/Fax

Practice location:
  • Phone: 281-824-1480
  • Fax: 281-220-6407
Mailing address:
  • Phone: 281-824-1480
  • Fax: 281-220-6407

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1045611
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License Number892718
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: