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NPI Code Detail

MEDICARE: DAVID WAYNE WITTY APRN

MEDICARE:   DAVID WAYNE WITTY  APRN
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 PractitionerC-APN.0992697-C-NPCO
2363LF0000XFamily Nurse PractitionerAP140689TX
3363LF0000XFamily Nurse Practitioner5021023NC

General Provider Information

NPI Number : 1518425149
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID WAYNE WITTY APRN
Provider Business Mailing Address
First Line : 5200 SUBURBAN DR
Second Line :
City : AUSTIN
State : TX
Zip : 78745-2335
Country : US
Telephone Number : 512-415-5942
Fax Number :
Provider Business Practice Location Address
First Line : 5200 SUBURBAN DR
Second Line :
City : AUSTIN
State : TX
Zip : 78745-2335
Country : US
Telephone Number : 512-415-5942
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2019
Last Update Date : 11/21/2024

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Directions to “ DAVID WAYNE WITTY APRN” Practice Location

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