Provider Demographics
NPI:1043077944
Name:TUPUSHEVA, NINA (FNP-C)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:
Last Name:TUPUSHEVA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8701 W PARMER LN
Mailing Address - Street 2:STE 2119
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78729
Mailing Address - Country:US
Mailing Address - Phone:512-387-3127
Mailing Address - Fax:512-368-9101
Practice Address - Street 1:8701 W PARMER LN STE 2119
Practice Address - Street 2:STE 2119
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78729
Practice Address - Country:US
Practice Address - Phone:512-387-3127
Practice Address - Fax:512-368-9101
Is Sole Proprietor?:No
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1055582363L00000X, 363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care