Provider Demographics
NPI:1558352385
Name:BOBECHE, DANNIECE (NP)
Entity Type:Individual
Prefix:MS
First Name:DANNIECE
Middle Name:
Last Name:BOBECHE
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 1:5525 S STAPLES ST
Mailing Address - Street 2:SUITE B1
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-5357
Mailing Address - Country:US
Mailing Address - Phone:361-985-0906
Mailing Address - Fax:361-985-6981
Practice Address - Street 1:5525 S STAPLES ST
Practice Address - Street 2:SUITE B1
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-5357
Practice Address - Country:US
Practice Address - Phone:361-985-0906
Practice Address - Fax:361-985-6981
Is Sole Proprietor?:No
Enumeration Date:2005-11-01
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX248781363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX191386501Medicaid
TX8Y1954OtherBLUE CROSS BLUE SHIELD
TX8J6703Medicare PIN