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NPI Code Detail

MEDICARE: BAILEY ELIZABETH WOHLEBER FNP-BC

MEDICARE: BAILEY ELIZABETH WOHLEBER FNP-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
1363L00000XNurse PractitionerAP129955TX

General Provider Information

NPI Number : 1376904862
Entity Type Code : Individual
Provider Name (Legal Business Name) : BAILEY ELIZABETH WOHLEBER FNP-BC
Provider Business Mailing Address
First Line : 9715 BURNET RD
Second Line : BLDG. 7, STE. 200
City : AUSTIN
State : TX
Zip : 78758-5215
Country : US
Telephone Number : 512-505-5500
Fax Number : 512-334-2702
Provider Business Practice Location Address
First Line : 2600 E MLK JR BLVD
Second Line :
City : AUSTIN
State : TX
Zip : 78702-1449
Country : US
Telephone Number : 512-505-5500
Fax Number : 512-334-2702
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2016
Last Update Date : 05/26/2021

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