Healthcare Provider Details

I. General information

NPI: 1508564329
Provider Name (Legal Business Name): DUSTY DAWN BEST APRN, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2023
Last Update Date: 02/21/2023
Certification Date: 02/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 WOODLINE DR
SPRING TX
77386-1977
US

IV. Provider business mailing address

1908 FOXTAIL PL
SPRING TX
77380-1833
US

V. Phone/Fax

Practice location:
  • Phone: 281-528-4100
  • Fax:
Mailing address:
  • Phone: 740-547-9931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1111038
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: