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
1	363LF0000X	Family Nurse Practitioner	C-APN.0992697-C-NP	CO
2	363LF0000X	Family Nurse Practitioner	AP140689	TX
3	363LF0000X	Family Nurse Practitioner	5021023	NC

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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