Healthcare Provider Details

I. General information

NPI: 1407997885
Provider Name (Legal Business Name): AMY GREENWOOD HEMINGWAY APRN, CPNP-AC/PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 11/05/2020
Certification Date: 11/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 MUELLER BLVD
AUSTIN TX
78723-3079
US

IV. Provider business mailing address

6225 PIPING ROCK LN
HOUSTON TX
77057-4407
US

V. Phone/Fax

Practice location:
  • Phone: 512-324-0091
  • Fax:
Mailing address:
  • Phone: 713-306-5962
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number558754
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License NumberAP109261
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: