Provider Demographics
NPI:1225705841
Name:ATUMA, CAROL N
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:N
Last Name:ATUMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2032 DRIPPING SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-5138
Mailing Address - Country:US
Mailing Address - Phone:469-471-1554
Mailing Address - Fax:
Practice Address - Street 1:2032 DRIPPING SPRINGS DR
Practice Address - Street 2:
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126-5138
Practice Address - Country:US
Practice Address - Phone:469-471-1554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1049434363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health