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NPI Code Detail

MEDICARE: KATHRYN RUTH SHIRLEY FNP

MEDICARE:   KATHRYN RUTH SHIRLEY  FNP
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
1363L00000XNurse Practitioner530719TX
2363LF0000XFamily Nurse PractitionerAP124445TX
3363L00000XNurse PractitionerAP124445TX

Other Identifiers

General Provider Information

NPI Number : 1639500465
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN RUTH SHIRLEY FNP
Provider Business Mailing Address
First Line : PO BOX 911230
Second Line :
City : DALLAS
State : TX
Zip : 75391-1230
Country : US
Telephone Number : 972-997-8000
Fax Number : 972-234-0813
Provider Business Practice Location Address
First Line : 12221 RENFERT WAY STE 300
Second Line :
City : AUSTIN
State : TX
Zip : 78758-5453
Country : US
Telephone Number : 512-873-8900
Fax Number : 512-873-8913
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2013
Last Update Date : 06/05/2024

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Directions to “ KATHRYN RUTH SHIRLEY FNP” Practice Location

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