Healthcare Provider Details

I. General information

NPI: 1720460702
Provider Name (Legal Business Name): SUNNY AUSTIN RN, BSN, CNOR, RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2015
Last Update Date: 07/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 MILLER RD
ROWLETT TX
75088-5604
US

IV. Provider business mailing address

PO BOX 938
ROWLETT TX
75030-0938
US

V. Phone/Fax

Practice location:
  • Phone: 214-755-8501
  • Fax: 214-764-0880
Mailing address:
  • Phone: 214-755-8501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number595232
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: