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General NPI Number Information
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NPI Number | 1053103010
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Entity Type | Organization
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Legal Business Name | NEXXUS LEVEL PRIMARY CARE & VETERAN ADVOCATE
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Dates
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Enumeration Date | 05/17/2025
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 11201 DENAE DR
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City | SAN ANTONIO
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State | TX
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Zip | 78233-5487
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Country | US
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Telephone | 210-286-0961
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Fax |
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Provider Business Mailing Address
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Address Line | 11201 DENAE DR
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City | SAN ANTONIO
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State | TX
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Zip | 78233-5487
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Country | US
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Telephone | 210-286-0961
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Fax |
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Authorized Official
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Title or Position | NP-C
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Name | MS. CONSTANCE HENRY
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Credential | AGPC
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Telephone | 210-286-0961
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 202C00000X
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Taxonomy Name | Independent Medical Examiner Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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