Blue Agave Wound Care Solutions LLC
Registered Nurse, Wound Care in Austin, TX. Organization (NPI-2).
NPI number1851869234
StatusActive
Last updated in NPPESNov 5, 2018
Details
- NPI
- 1851869234
- Entity type
- Organization (NPI-2)
- Legal business name
- Blue Agave Wound Care Solutions LLC
- Organization subpart
- No
- Enumeration date
- Nov 5, 2018
- Last updated
- Nov 5, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WW0000X | Registered Nurse, Wound Care | – | – | Yes |
| 163WH0200X | Registered Nurse, Home Health | – | – | |
| 363L00000X | Nurse Practitioner | – | – | |
| 364SH0200X | Clinical Nurse Specialist, Home Health | – | – | |
| 374U00000X | Home Health Aide | – | – |
Practice location
10109 Lake Creek Pkwy Unit 170434Austin, TX 78717-0119
Phone 844-275-3822
Mailing address
Po Box 170434Austin, TX 78717-0027
Phone 844-275-3822
Authorized official
Richard Carney
Member LLC
6195686800
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