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General NPI Number Information
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NPI Number | 1992389985
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Entity Type | Individual
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Provider Name | DIEDRA LYN TROUTMAN FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 05/06/2021
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Last Update Date | 05/18/2021
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Provider Practice Location Address
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Address Line | 23802 HIGHWAY 59 N
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City | KINGWOOD
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State | TX
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Zip | 77339-1510
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Country | US
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Telephone | 281-312-5400
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Fax | 281-312-5440
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Provider Business Mailing Address
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Address Line | 16339 GENTLE SLOPE LN
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City | HOUSTON
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State | TX
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Zip | 77044-6588
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Country | US
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Telephone | 806-640-3302
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 762767
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License Number State | TX
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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 | 1037451
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License Number State | TX
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