Provider Demographics
NPI:1427357011
Name:JOAN MAXFIELD PLLC
Entity Type:Organization
Organization Name:JOAN MAXFIELD PLLC
Other - Org Name:JOAN MAXFIELD, FNP-BC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/SOLE MBR
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAXFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:512-352-3200
Mailing Address - Street 1:PO BOX 821
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:TX
Mailing Address - Zip Code:76574-0821
Mailing Address - Country:US
Mailing Address - Phone:512-352-3200
Mailing Address - Fax:512-352-3201
Practice Address - Street 1:601A MALLARD LN
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:TX
Practice Address - Zip Code:76574-1214
Practice Address - Country:US
Practice Address - Phone:512-352-3200
Practice Address - Fax:512-352-3201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-22
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX228356363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty