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General NPI Number Information
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NPI Number | 1811655392
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Entity Type | Individual
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Provider Name | VANESSA MADRID PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 12/02/2021
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 8913 COLLINFIELD DR UNIT 1
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City | AUSTIN
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State | TX
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Zip | 78758-6704
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Country | US
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Telephone | 877-800-5722
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Fax |
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Provider Business Mailing Address
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Address Line | 2423 WILLIAMS DR STE 107
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City | GEORGETOWN
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State | TX
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Zip | 78628-3269
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Country | US
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Telephone |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1059224
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License Number State | TX
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