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General NPI Number Information
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NPI Number | 1376897546
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Entity Type | Individual
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Provider Name | STEPHANIE LAN DANG ACNS-BC, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 11/09/2012
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Last Update Date | 05/14/2020
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Provider Practice Location Address
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Address Line | 1013 W 9TH ST
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City | AUSTIN
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State | TX
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Zip | 78703-4923
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Country | US
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Telephone | 512-937-3575
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Fax |
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Provider Business Mailing Address
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Address Line | 7337 MENCHACA RD UNIT 14
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City | AUSTIN
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State | TX
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Zip | 78745-5336
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Country | US
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Telephone | 210-367-9953
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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 | 364SA2200X
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Taxonomy Name | Adult Health Clinical Nurse Specialist
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License Number | 791452
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP122750
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License Number State | TX
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