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General NPI Number Information
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NPI Number | 1205407335
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Entity Type | Individual
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Provider Name | NISSA ROSE GALVAN AGACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/09/2021
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Last Update Date | 02/08/2023
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Provider Practice Location Address
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Address Line | 1500 RED RIVER ST
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City | AUSTIN
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State | TX
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Zip | 78701-1918
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Country | US
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Telephone | 512-689-6824
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Fax |
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Provider Business Mailing Address
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Address Line | 1345 PHILOMENA ST STE 410.3
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City | AUSTIN
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State | TX
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Zip | 78723-3210
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 1046956
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License Number State | TX
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