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General NPI Number Information
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NPI Number | 1679789291
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Entity Type | Individual
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Provider Name | DENIM RENEE ERVIN FNP-C
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Gender | Female
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 02/15/2019
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Provider Practice Location Address
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Address Line | 3550 NE LOOP 286
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City | PARIS
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State | TX
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Zip | 75460-5004
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Country | US
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Telephone | 903-785-0031
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Fax | 903-784-6755
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Provider Business Mailing Address
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Address Line | PO BOX 911230
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City | DALLAS
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State | TX
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Zip | 75391-1230
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Country | US
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Telephone | 972-997-8000
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Fax | 972-234-0813
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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 | A03157
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R26629
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95843
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License Number State | OK
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Taxonomy #4
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | AP115721
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License Number State | TX
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