Provider Demographics
NPI:1003141144
Name:MOUNKHOUNE, YVONNE MARIE (BSN, RN, MA)
Entity Type:Individual
Prefix:MRS
First Name:YVONNE
Middle Name:MARIE
Last Name:MOUNKHOUNE
Suffix:
Gender:F
Credentials:BSN, RN, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2559 WESTERN TRAILS BLVD STE 301
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-1569
Mailing Address - Country:US
Mailing Address - Phone:512-962-3838
Mailing Address - Fax:512-318-2538
Practice Address - Street 1:2559 WESTERN TRAILS BLVD STE 301
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1569
Practice Address - Country:US
Practice Address - Phone:512-815-2559
Practice Address - Fax:512-301-2538
Is Sole Proprietor?:No
Enumeration Date:2009-10-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX951144163W00000X
MSR868600163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3404547Medicaid