MEDICARE: AUTUMN FOLLETT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP2300X	Primary Care Nurse Practitioner	1231649	TX

General Provider Information

NPI Number	:	1104761071
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUTUMN FOLLETT

Provider Business Mailing Address
First Line	:	5915 SILVER SPRINGS DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-4117
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5915 SILVER SPRINGS DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-4117
Country	:	US
Telephone Number	:	915-845-4024
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2026
Last Update Date	:	04/29/2026

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Directions to “ AUTUMN FOLLETT ” Practice Location

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