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NPI Code Detail

MEDICARE: GENESIS: YOUR FIRST STEP, PLLC

MEDICARE: GENESIS: YOUR FIRST STEP, PLLC
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerAP128692TX

General Provider Information

NPI Number : 1467827873
Entity Type Code : Organization
Provider Name (Legal Business Name) : GENESIS: YOUR FIRST STEP, PLLC
Provider Business Mailing Address
First Line : 7760 ALABAMA ST
Second Line :
City : EL PASO
State : TX
Zip : 79904-3136
Country : US
Telephone Number : 915-757-7999
Fax Number : 915-757-8004
Provider Business Practice Location Address
First Line : 7760 ALABAMA ST
Second Line :
City : EL PASO
State : TX
Zip : 79904-3136
Country : US
Telephone Number : 915-757-7999
Fax Number : 915-757-8004
Authorized Official
Title or Position : OWNER
Name : IRENE LOUISA DUNN
Credential :
Telephone Number : 915-757-7999
Provider Enumeration Date : 12/10/2015
Last Update Date : 12/10/2015

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Directions to “GENESIS: YOUR FIRST STEP, PLLC ” Practice Location

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