Provider Demographics
NPI:1518225291
Name:SOUDERS, AMY ELIZABETH (ACNP)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:ELIZABETH
Last Name:SOUDERS
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:400 W ARBROOK BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-3180
Mailing Address - Country:US
Mailing Address - Phone:972-647-8404
Mailing Address - Fax:972-641-8398
Practice Address - Street 1:400 W ARBROOK BLVD STE 300
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-3180
Practice Address - Country:US
Practice Address - Phone:972-647-8404
Practice Address - Fax:972-641-8398
Is Sole Proprietor?:No
Enumeration Date:2012-05-01
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX663390363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care