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NPI Code Detail

MEDICARE: SALLIE ANN HUMPHRIES APRN, ACNP-BC

MEDICARE: SALLIE ANN HUMPHRIES APRN, ACNP-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
1363LA2100XAcute Care Nurse PractitionerAP120135TX
2163W00000XRegistered Nurse744544TX

General Provider Information

NPI Number : 1578964318
Entity Type Code : Individual
Provider Name (Legal Business Name) : SALLIE ANN HUMPHRIES APRN, ACNP-BC
Provider Business Mailing Address
First Line : 5115 FANNIN ST STE 801
Second Line :
City : HOUSTON
State : TX
Zip : 77004-5870
Country : US
Telephone Number : 713-790-0841
Fax Number : 713-790-9663
Provider Business Practice Location Address
First Line : 5115 FANNIN ST STE 801
Second Line :
City : HOUSTON
State : TX
Zip : 77004-5870
Country : US
Telephone Number : 713-790-0841
Fax Number : 713-790-9663
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2014
Last Update Date : 05/15/2026

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