Healthcare Provider Details

I. General information

NPI: 1801307897
Provider Name (Legal Business Name): TRISTA RANTON MSN, RN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2017
Last Update Date: 07/21/2022
Certification Date: 01/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 HILL COUNTRY DR
KERRVILLE TX
78028
US

IV. Provider business mailing address

712 HILL COUNTRY DR STE 100
KERRVILLE TX
78028-6166
US

V. Phone/Fax

Practice location:
  • Phone: 830-258-6237
  • Fax:
Mailing address:
  • Phone: 830-890-5181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP135509
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: