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NPI Code Detail

MEDICARE: MISTI BROWN MAAG

MEDICARE:   MISTI BROWN MAAG
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
1163W00000XRegistered Nurse714936TX
2363LP0808XPsychiatric/Mental Health Nurse PractitionerAP145839TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1714936OTHERTXTEXAS BOARD OF NURSING
2AP145839OTHERTXTEXAS BOARD OF NURSING

General Provider Information

NPI Number : 1184252025
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISTI BROWN MAAG
Provider Business Mailing Address
First Line : 2206 CHEYENNE PASS
Second Line :
City : SALADO
State : TX
Zip : 76571-6072
Country : US
Telephone Number : 512-508-1482
Fax Number :
Provider Business Practice Location Address
First Line : 1 CHISHOLM TRAIL RD STE 5100
Second Line :
City : ROUND ROCK
State : TX
Zip : 78681-5090
Country : US
Telephone Number : 512-273-7629
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2020
Last Update Date : 04/15/2020

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Directions to “ MISTI BROWN MAAG ” Practice Location

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