Healthcare Provider Details

I. General information

NPI: 1831734029
Provider Name (Legal Business Name): VIVIENNE OWUSU-APPIAH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: VIVIENNE OWUSU-APPIAH ABBERLEY

II. Dates (important events)

Enumeration Date: 11/11/2019
Last Update Date: 11/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10325 LAKE BEND TRL
HURST TX
76053-7818
US

IV. Provider business mailing address

10325 LAKE BEND TRL
HURST TX
76053-7818
US

V. Phone/Fax

Practice location:
  • Phone: 682-478-7597
  • Fax:
Mailing address:
  • Phone: 682-478-7597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP143664
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: