Provider Demographics
NPI:1548409907
Name:HERMANN, CAROLINE (NP)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:HERMANN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1283 RECORD CROSSING RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-6001
Mailing Address - Country:US
Mailing Address - Phone:214-941-1050
Mailing Address - Fax:
Practice Address - Street 1:1283 RECORD CROSSING RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-6001
Practice Address - Country:US
Practice Address - Phone:214-941-1050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-09
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX671886367A00000X
TXAP110365363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife