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General NPI Number Information
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NPI Number | 1790251015
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Entity Type | Individual
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Provider Name | AMY KRISTINE PONZIO APRN
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Gender | Female
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Dates
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Enumeration Date | 10/15/2018
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 2700 E 29TH ST STE 260
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City | BRYAN
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State | TX
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Zip | 77802-2587
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Country | US
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Telephone | 979-774-0012
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Fax | 979-774-4636
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Provider Business Mailing Address
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Address Line | 2801 FRANCISCAN DR
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City | BRYAN
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State | TX
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Zip | 77802-2544
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Country | US
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Telephone | 979-731-6000
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | AP139086
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License Number State | TX
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