Healthcare Provider Details

I. General information

NPI: 1124736376
Provider Name (Legal Business Name): PEYTON NICOLE BRONSON APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2022
Last Update Date: 01/08/2024
Certification Date: 01/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 S COULTER ST
AMARILLO TX
79106-1786
US

IV. Provider business mailing address

1400 S COULTER ST
AMARILLO TX
79106-1786
US

V. Phone/Fax

Practice location:
  • Phone: 806-414-9800
  • Fax: 806-354-5536
Mailing address:
  • Phone: 806-414-9800
  • Fax: 806-354-5536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1098370
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: