Healthcare Provider Details

I. General information

NPI: 1376148783
Provider Name (Legal Business Name): STEPHANIE MARIE BORJAS MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2020
Last Update Date: 12/02/2020
Certification Date: 12/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11813 BEE CAVES RD STE B
BEE CAVE TX
78738-5572
US

IV. Provider business mailing address

4011 AYALA DR
AUSTIN TX
78725-1849
US

V. Phone/Fax

Practice location:
  • Phone: 512-505-8645
  • Fax:
Mailing address:
  • Phone: 512-810-9110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1014032
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: