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NPI Code Detail

MEDICARE: JONATHAN A MCNUTT

MEDICARE:   JONATHAN A MCNUTT
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
1101YM0800XMental Health Counselor80470TX

General Provider Information

NPI Number : 1598419699
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN A MCNUTT
Provider Business Mailing Address
First Line : 8805 NORTH PLZ APT 1384
Second Line :
City : AUSTIN
State : TX
Zip : 78753-5224
Country : US
Telephone Number : 512-332-6230
Fax Number :
Provider Business Practice Location Address
First Line : 8805 NORTH PLZ APT 1384
Second Line :
City : AUSTIN
State : TX
Zip : 78753-5224
Country : US
Telephone Number : 512-332-6230
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2022
Last Update Date : 02/08/2022

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Directions to “ JONATHAN A MCNUTT ” Practice Location

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