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NPI Code Detail

MEDICARE: AMANDA CHRISTINE AZEVEDO FNP-C

MEDICARE: AMANDA CHRISTINE AZEVEDO FNP-C
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
1363LF0000XFamily Nurse PractitionerAP140221TX

General Provider Information

NPI Number : 1356805220
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA CHRISTINE AZEVEDO FNP-C
Provider Business Mailing Address
First Line : 211 E 7TH ST STE 700
Second Line :
City : AUSTIN
State : TX
Zip : 78701-3218
Country : US
Telephone Number : 888-478-8432
Fax Number :
Provider Business Practice Location Address
First Line : 322 S HAMPTON RD
Second Line :
City : DALLAS
State : TX
Zip : 75208-5617
Country : US
Telephone Number : 888-478-8432
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2019
Last Update Date : 06/13/2024

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Directions to “ AMANDA CHRISTINE AZEVEDO FNP-C” Practice Location

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