=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649954215
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | APARNA MARWAHA AG-ACNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/13/2023
-----------------------------------------------------
Last Update Date | 09/19/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14111 KING RD STE 320
-----------------------------------------------------
City | FRISCO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75036-0810
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 469-888-4890
-----------------------------------------------------
Fax | 866-292-0929
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14111 KING RD STE 320
-----------------------------------------------------
City | FRISCO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75036-0810
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 469-888-4890
-----------------------------------------------------
Fax | 866-292-0929
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LA2100X
-----------------------------------------------------
Taxonomy Name | Acute Care Nurse Practitioner
-----------------------------------------------------
License Number | 1120693
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------