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1376800235
ANNESSA FAYE VAN DE WALLE
AUSTIN, TX
NPI
1376800235
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Former Name
ANNESSA FAYE GREEN
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: TX 618160)
Enumeration Date
2012-04-17
Last Update Date
2012-04-17
Business Address
-- ANNESSA FAYE VAN DE WALLE fnp
291 HARRIS DR
AUSTIN, TX 78737-4606
Phone number: 817-366-7542
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Mailing Address
-- ANNESSA FAYE VAN DE WALLE fnp
291 HARRIS DR
AUSTIN, TX 78737-4606
Phone number: 817-366-7542
Copy
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