=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508362526
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HAWNA MUMM MSN, APRN, FNP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/30/2018
-----------------------------------------------------
Last Update Date | 02/26/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2905 SAN GABRIEL ST STE 100
-----------------------------------------------------
City | AUSTIN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78705-3548
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-815-0123
-----------------------------------------------------
Fax | 512-861-6206
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3200 COUNTY ROAD 200
-----------------------------------------------------
City | LIBERTY HILL
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78642-3863
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-876-8020
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | AP136842
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------