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General NPI Number Information
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NPI Number | 1295222149
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Entity Type | Individual
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Provider Name | KATHERINE FRANCES WAVERING FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 04/17/2018
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Last Update Date | 10/24/2018
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Provider Practice Location Address
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Address Line | 3140 HORIZON RD STE 101
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City | ROCKWALL
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State | TX
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Zip | 75032-7816
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Country | US
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Telephone | 972-772-5522
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Fax | 469-402-1565
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Provider Business Mailing Address
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Address Line | 3140 HORIZON RD STE 101
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City | ROCKWALL
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State | TX
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Zip | 75032-7816
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Country | US
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Telephone | 972-772-5522
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Fax | 469-402-1565
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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 | AP137393
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License Number State | TX
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