Healthcare Provider Details

I. General information

NPI: 1588104509
Provider Name (Legal Business Name): LAUREN DUMPIT FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2017
Last Update Date: 02/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15808 RANCH ROAD 620 N STE 100
AUSTIN TX
78717-4923
US

IV. Provider business mailing address

15808 RANCH ROAD 620 N STE 100
AUSTIN TX
78717-4923
US

V. Phone/Fax

Practice location:
  • Phone: 512-244-3554
  • Fax: 512-244-2942
Mailing address:
  • Phone: 512-244-3554
  • Fax: 512-244-2942

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP133418
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: