Healthcare Provider Details

I. General information

NPI: 1699175984
Provider Name (Legal Business Name): LINDSEY WARREN DAVIS FPMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2014
Last Update Date: 02/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7020 EASY WIND DR STE 130
AUSTIN TX
78752-2373
US

IV. Provider business mailing address

7020 EASY WIND DR STE 130
AUSTIN TX
78752-2373
US

V. Phone/Fax

Practice location:
  • Phone: 512-628-1898
  • Fax: 512-600-8149
Mailing address:
  • Phone: 512-628-1898
  • Fax: 512-600-8149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP 126151
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: