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General NPI Number Information
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NPI Number | 1174209852
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Entity Type | Individual
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Provider Name | ELIZABETH KRISTINE VEGA DNP APRN FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 06/26/2023
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Last Update Date | 07/20/2023
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Provider Practice Location Address
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Address Line | 1620 MCCULLOUGH AVE
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City | SAN ANTONIO
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State | TX
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Zip | 78212-4434
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Country | US
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Telephone | 210-239-0903
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Fax |
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Provider Business Mailing Address
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Address Line | 122 ROY SMITH ST APT 1147
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City | SAN ANTONIO
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State | TX
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Zip | 78215-1364
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1129358
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License Number State | TX
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