MEDICARE: CHRISTIN MARIE MUDD AGACNP-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
1	363LA2100X	Acute Care Nurse Practitioner	AP127112	TX

General Provider Information

NPI Number	:	1629467162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTIN MARIE MUDD AGACNP-BC

Provider Business Mailing Address
First Line	:	3805 DESERT WILLOW DR
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76208-7600
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5323 HARRY HINES BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75390-7738
Country	:	US
Telephone Number	:	214-645-8300
Fax Number	:

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

Provider Enumeration Date	:	01/21/2015
Last Update Date	:	05/21/2025

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