MEDICARE: MRS. AMY HERRIN KOWALSKI ACNS-BC

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	364SA2200X	Adult Health Clinical Nurse Specialist	760893	TX

General Provider Information

NPI Number	:	1346550597
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMY HERRIN KOWALSKI ACNS-BC

Provider Business Mailing Address
First Line	:	2301 W NORTH LOOP BLVD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78756-2326
Country	:	US
Telephone Number	:	512-452-2506
Fax Number	:	512-371-0187

Provider Business Practice Location Address
First Line	:	2301 W NORTH LOOP BLVD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78756-2326
Country	:	US
Telephone Number	:	512-452-2506
Fax Number	:	512-371-0187

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

Provider Enumeration Date	:	10/20/2010
Last Update Date	:	02/24/2015

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