MEDICARE: NADINE DONGNANG NJOCK APRN-CNP

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	363L00000X	Nurse Practitioner	1019903	TX
2	163W00000X	Registered Nurse	886320	TX

General Provider Information

NPI Number	:	1538640339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NADINE DONGNANG NJOCK APRN-CNP

Provider Business Mailing Address
First Line	:	5522 LONE STAR PKWY STE 101
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78253-6719
Country	:	US
Telephone Number	:	210-298-4900
Fax Number	:

Provider Business Practice Location Address
First Line	:	5522 LONE STAR PKWY STE 101
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78253-6719
Country	:	US
Telephone Number	:	210-298-4900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/28/2018
Last Update Date	:	04/26/2021

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