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General NPI Number Information
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NPI Number | 1811223001
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Entity Type | Individual
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Provider Name | ALICIA KAREN SU RN MSN
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Gender | Female
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Dates
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Enumeration Date | 10/23/2009
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Last Update Date | 01/04/2022
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Provider Practice Location Address
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Address Line | 4375 BOOTH CALLOWAY RD STE 505
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City | NORTH RICHLAND HILLS
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State | TX
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Zip | 76180-8359
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Country | US
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Telephone | 972-566-4822
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 W COLLEGE ST SUITE 110
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City | GRAPEVINE
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State | TX
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Zip | 76051-3580
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Country | US
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Telephone | 817-424-5959
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Fax | 817-416-7441
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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 | 609770
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 609770
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License Number State | TX
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