Organization · NPI-2

Abilene Family Medical Clinic, LLC

Nurse Practitioner · Abilene, TX

NPI number1376954743
StatusActive
Last updated in NPPESMay 19, 2014

Details

NPI
1376954743
Entity type
Organization (NPI-2)
Legal business name
Abilene Family Medical Clinic, LLC
Organization subpart
No
Enumeration date
May 19, 2014
Last updated
May 19, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363L00000X Nurse Practitioner603150TXYes

Practice location

4542 S 14th St
Abilene, TX 79605-4737

Phone 325-701-9961

Mailing address

4542 S 14th St
Abilene, TX 79605-4737

Authorized official

Freddie R Johnson
Owner
3257019961

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