Provider Demographics
NPI:1407368772
Name:MENDOZA, DEANNA (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:MENDOZA
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:DEANNA
Other - Middle Name:
Other - Last Name:POTTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN,FNP-C
Mailing Address - Street 1:6210 E HWY 290
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-1142
Mailing Address - Country:US
Mailing Address - Phone:512-483-9596
Mailing Address - Fax:512-406-6216
Practice Address - Street 1:151 EXCHANGE BLVD STE 500
Practice Address - Street 2:
Practice Address - City:HUTTO
Practice Address - State:TX
Practice Address - Zip Code:78634-5381
Practice Address - Country:US
Practice Address - Phone:512-846-1244
Practice Address - Fax:512-406-7324
Is Sole Proprietor?:No
Enumeration Date:2017-10-26
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP135626363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily